Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: no known allergies / adverse drug reactions attending: chief complaint: brbpr, anemia major surgical or invasive procedure: enteroscopy history of present illness: mr. is a 49-year-old male with history of anemia and gi bleeds who presents with bright red blood per rectum and hematemesis x1. he has had extensive workup done both here in as well some including endoscopy, colonoscopy, capsule study, tagged red blood cell scan. on tagged red blood cell scan apparently there was an area that showed possible source of the patient's anemia however he does not have records and does not remember exactly. . the patient yesterday evening went to to be further eval for his palpitations and bloody stool. currently he says he has not had a bloody bowel movement for the past 8-12 hours. last episode was yesterday evening. otherwise the patient denies any hematemesis or coffee-ground emesis. the patient denies any chest pain, shortness of breath, nausea, vomiting, and diarrhea. he does not have any fevers or chills currently. he also does not have any abdominal pain. . in the ed, initial vs: 97.5, 103, 114/70, 20, 99%. his initial hematocrit was 18.6, repeat the same. they attempted to contact the hospital where tagged rbc scan was done however medical records was closed, number is (. he also recieved 1st unit prbc, needs 2nd unit still. pt asymptomatic currently, guiac neg. guiaic trace positive without frank blood in vault. . on arrival to the micu, he is feeling much better. his anemia symptoms (sob, dizziness, weakness) have resolved with 1 u prbcs. he also has not had anymore bleeding today. has never had pain with his bloody bowel movements but does get nausea. never had hematemesis. past medical history: -hx of gi bleeds x 2. most recent bleed in , found to have duodenal ulcer at hospital, which was clipped vs cauterized -hyperlipidemia -s/p motorcycle accident , with bowel resection, ileostomy and reversal. social history: lives at home with wife and children. remote smoker (quit >20 years ago). denies illicits or etoh intake. family history: mother: mi at age 70. father: mi at age 64. three children (two sons and one daughter) are healthy. no known gi disease in the family. physical exam: on admission: vitals: t: 96.8, bp:137/65, p:101, r:18, o2: 100% ra general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp 12-14 cm, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: mildly firm but non-tender, non-distended, bowel sounds present, no organomegaly, well healed midline scar gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: cnii-xii intact, 5/5 strength upper/lower extremities, grossly normal sensation, gait deferred on discharge: vitals - 97.7 98/58 83 20 97%ra ga: aox3, nad heent: perrla. mmm. no lymphadenopathy. neck supple. cards: rrr, s1/s2 heard. no murmurs/gallops/rubs. pulm: ctab no crackles or wheezes abd: soft, nt nd, +bs. no organomegaly. extremities: wwp, no edema. skin: warm and dry neuro/psych: awake, alert and oriented. moving all extremities. pertinent results: labs: on admission - 05:28pm blood hct-25.5* 09:28am blood wbc-7.3 rbc-3.47*# hgb-9.6*# hct-28.8*# mcv-83 mch-27.6 mchc-33.4 rdw-16.0* plt ct-299 08:48pm blood hct-20.5* 10:40am blood wbc-6.3 rbc-2.30*# hgb-6.2*# hct-18.6*# mcv-81* mch-27.1 mchc-33.5 rdw-16.5* plt ct-276 09:28am blood pt-13.2* ptt-28.0 inr(pt)-1.2* 08:48pm blood pt-13.3* ptt-30.4 inr(pt)-1.2* 10:40am blood pt-13.6* ptt-28.0 inr(pt)-1.3* 09:28am blood glucose-89 urean-11 creat-0.8 na-138 k-4.4 cl-104 hco3-27 angap-11 10:40am blood glucose-110* urean-17 creat-0.7 na-136 k-4.2 cl-104 hco3-26 angap-10 10:40am blood alt-22 ast-20 alkphos-56 totbili-1.3 09:28am blood calcium-8.1* phos-3.3 mg-2.4 10:40am blood albumin-3.3* calcium-8.3* phos-3.3 mg-2.2 on discharge - 06:15am blood wbc-5.9 rbc-3.89* hgb-10.6* hct-32.2* mcv-83 mch-27.4 mchc-33.0 rdw-16.9* plt ct-308 06:15am blood glucose-110* urean-11 creat-0.9 na-138 k-3.8 cl-103 hco3-27 angap-12 06:15am blood calcium-8.2* phos-3.5 mg-2.4 studies: . cta pelvis - impression: 1. no evidence of active gastrointestinal hemorrhage. there are some unusual varices about the proximal jejunum shortly beyond what appears to represent a duodenal jejunal anastomotic site although without suggestion of active bleeding. 2. exophytic nodule (10 mm) along the lower pole of the left kidney, not significantly changed; it may represent an unusual lobulation but a small solid tumor such as renal cell carcinoma is a differential consideration. follow-up mr evaluation is suggested when clinically appropriate to evaluate further. at that time, a probably hemorrhagic or proteinaceous cyst in the right upper pole could also be reassessed. 3. stable benign bony findings. 4. cholelithiasis. . us gallbladder - impression: mildly echogenic liver, suggestive of hepatic steatosis. no focal liver lesions. no ultrasound evidence of portal hypertension. . enteroscopy - impression: friability and erythema in the stomach antrum compatible with gastritis or gave friability, erythema and erosions in the duodenal-jejunal anastamosis compatible with mild anastamotic enteritis otherwise normal egd to mid-jejunum brief hospital course: mr. is a 49 year old male with history of gi bleed of unknown etiology even after extensive work-up who was transferred from an osh due to gi bleed. . # gi bleed: patient flew in from to the day pta. felt unwell during flight. had palpitations and noted pale skin. given these sx, he presented to osh for eval of brbpr and palpiations. transferred to at his request. in the ed, the patient was hd stable. initial labs showed a crit of 18.6. given 1 unit of prbcs in the ed and transferred to the micu. in the micu the patient received 2 additional transfusions. remained stable and transferred to the medical floor. on the floor, the patient received 1 additional unit of blood to maintain hct > 25. no further episodes of bleeding. underwent push enteroscopy that showed friability and erythema in the stomach antrum compatible with gastritis or gave. friability, erythema and erosions in the duodenal-jejunal anastamosis compatible with mild anastamotic enteritis. records were obtained from patient's hospitalization in and it was decided that no further gi interventions were necessary. source of bleeding believed to be related to prior surgical anastamosis. seen by surgery who agreed that no furhter inpatient work-up was ncessary. will be followed by gi and surgery in clinic. . #. chronic anemia: baseline hematocrit is 28 but presented with a hematocrit of 18. transfused 4 units over hospital course. had a wide rdw. most likely iron deficiency due to long history of melena and other forms of gib. continued on home iron supplementation. . #. hyperlipidemia: continued home statin. . #. depression: continued home nortriptyline. . #. transitional issues: - follow-up with gi and surgery for further evaluation of intermittent gi bleeding medications on admission: simvastatin 40 mg qhs protonix 40 mg b.i.d. iron 325 mg b.i.d. alendronate qweekly nortriptyline 50 mg qhs discharge medications: 1. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 2. alendronate 70 mg tablet sig: one (1) tablet po qweek (). disp:*4 tablet(s)* refills:*0* 3. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). disp:*60 tablet, delayed release (e.c.)(s)* refills:*0* 4. ferrous sulfate 324 mg (65 mg iron) tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* discharge disposition: home discharge diagnosis: gastrointestinal bleed; source unknown discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: it was a pleasure taking care of you at ! you were transferred here due to gastro-intestinal bleeding. in the hospital you were initially in the intensive care unit. you received 4 units of blood and were monitored closely. you underwent an enteroscopy that did not show any active bleeding. you were also seen by our surgeons who did not feel any immediate intervention was necessary. you will be discharged with plans for close follow-up with your primary care doctor, gastroenterology and surgery. see below for changes to your home medication regimen: 1) please stop nortryptiline. this medication was on your medication list however it does not appear you were taking it. see below for instructions regarding follow-up care: followup instructions: department: div. of gastroenterology when: tuesday at 2:00 pm with: , md building: ra (/ complex) campus: east best parking: main garage name: ,devina location: health center address: , , phone: when: wednesday, , 2:45 pm department: general surgery/ when: thursday at 1:30 pm with: acute care clinic building: lm bldg () campus: west best parking: garage procedure: other endoscopy of small intestine diagnoses: other and unspecified noninfectious gastroenteritis and colitis acute posthemorrhagic anemia iron deficiency anemia secondary to blood loss (chronic) depressive disorder, not elsewhere classified mononeuritis of lower limb, unspecified other and unspecified hyperlipidemia unspecified disorder of kidney and ureter personal history of other injury 

Answer: The patient is high likely exposed to