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: patient recorded as having no known allergies to drugs attending: chief complaint: 1. sob x 1 week 2. intermittent black stool for 6 months major surgical or invasive procedure: upper endoscopy colonoscopy history of present illness: this is an 80 yo f who presents to the ed with sob and le edema x1 week. on arrival to the ed, she was unable to speak in full sentences and was wheezing. on further questioning, she claims that she had not been taking her usual dose of lasix for one week. her presciption had ran out. she also notes a 6 month history of intermittent black stool. she has discussed this with her pcp, . . her most recent occult blood in was negative and according to dr. , the stool was brown, not black as she describes it. patient also claims that she has occasional brbpr on straining with bms, with a history of hemorrhoids. she is on a daily asa, and denies other nsaid use. she has no history of alcohol consumption. denies abd pain/nausea/vomitting/hemetemesis. on ros, she denies chest pain/fever/ chills/changes in bowel habit/headache/hemeturia/changes in diet. past medical history: 1. dm ii 2. htn 3. pulmonary hypertension 4. increased cholesterol 5. chroninc low back pain and sciatica social history: denies etoh, ivda, or tob use. physical exam: bp 150/58 p70 gen: comfortable, pale elderly russian speaking female lying in bed in nad. heent: perrl. anicteric. mmm. pale conjunctiva neck: supple. no masses or lad. jvd 8-10 cm. lungs: diffuse crackles. cardiac: rrr. s1/s2. ii/vi systolic m heard best at apex. abd: soft, obese, nt, nd, +nabs. no rebound or guarding. extrem: 3+ pitting edema b/l, palpable dp pulses neuro: cn ii-vii intact, musc strength ue/le pertinent results: 08:14pm hgb-5.7* calchct-17 04:22pm urine hours-random 04:22pm urine gr hold-hold 04:22pm urine color-straw appear-clear sp -1.009 04:22pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 04:22pm urine rbc-<1 wbc-<1 bacteria-rare yeast-none epi-0-2 04:18pm pt-13.3 ptt-29.5 inr(pt)-1.1 03:21pm glucose-169* urea n-86* creat-1.1 sodium-142 potassium-4.9 chloride-103 total co2-24 anion gap-20 03:21pm ck(cpk)-38 03:21pm ck-mb-notdone ctropnt-<0.01 03:21pm vit b12-182* 03:21pm wbc-10.2# rbc-1.92*# hgb-5.4*# hct-17.0*# mcv-88 mch-27.9 mchc-31.6 rdw-17.2* 03:21pm neuts-77.8* lymphs-18.0 monos-3.0 eos-0.7 basos-0.5 03:21pm hypochrom-3+ anisocyt-1+ microcyt-1+ 03:21pm plt count-362# brief hospital course: 80 yo f w/ dm2, htn, pa htn p/w sob and le edema x1 week, now with severe anemia (hct of 17 noted by her pcp) thought to be secondary to ugib, hemodynamically stable s/p 6 units of bld w/ increase of hct to 30. serial hcts q 6 hrs remained stable at 30. pt had egd in ed () which revealed granularity, friability and erythema in the stomach body, fundus and antrum compatible with acute gastritis (biopsy obtained). erythema in the duodenal bulb compatible with duodenitis. ulcer in the distal bulb. otherwise normal egd to second part of the duodenum. echo:() 1. the left atrium is mildly dilated. 2. the left ventricular cavity size is normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef>55%). 3. the aortic valve leaflets are mildly thickened. mild (1+) aortic regurgitation is seen. 4. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. 5. compared with the findings of the prior study (tape reviewed) of , there has been no significant change. 1. gib with increased bun, likely ugib, however lgib initially considered as well. pt had 2 large bore iv's placed. ng lavage was positive as well as stool guiacs. egd as above. no active bleed noted however ulcer and gastritis likely source of anemia. ulcer thought to be secondary to nsaid use vs h. pylori. will treat for h.pylori if indicated. pt will follow up with gi. asa was held secondary to bleed. losartan was initially held, then restarted at half normal dose. nsaids were avoided. initially given iv ppi which was then changed to po. colonoscopy performed was reported to be normal. 2. cardiac. ekg changes (nsr at 84, nl axis and intervals, twi iii, twi v1-v4). pt was ruled out for mi with three sets of neg cardiac enzymes. she denied cp. ecg changes likely secondary to demand ischemia from severe anemia. she was initially monitored on tele with no events. an echo done on , as above (lvef>55%). sob most likely due to discontinuation of lasix for one week in setting of diastolic chf. treated with 40 of lasix iv (held off on diuresis intially secondary to concern for gi bld). 3. resp. cxr done on without overt evidence of chf or pneumonia. findings suggestive of pulmonary artery hypertension. she required o2 supplementation during her stay and was noted to have ra sats in the 80's with ambulation likely secondary to pa htn. she was sent home on supplemental o2. a repeat cxr was suggestive of pulm congestion. lasix given as above. 4. dm2. initially bld sugars controlled with riss, oral hyperglycemics were restarted prior to discharge. 5. anemia secondary to gastritis and pud, as well as fe/vit b12 def. she was transfused a total of 6 units of prbc's and her hct was monitored q 6 hrs. she was started on vit b12 supplementation. she was continued on niferex. medications on admission: 1. niferex 150 2. metformin 850 tid 3. losartan 50 4. rosiglitazone 8 qd 5. lipitor 20 6. asa 81 7. lasix 40 8. paxil 20 discharge medications: 1. atorvastatin calcium 20 mg tablet sig: one (1) tablet po qd (once a day). 2. paroxetine hcl 20 mg tablet sig: one (1) tablet po qd (once a day). 3. metformin hcl 850 mg tablet sig: one (1) tablet po tid (3 times a day). 4. rosiglitazone maleate 8 mg tablet sig: one (1) tablet po qd (once a day). 5. polysaccharide iron complex 150 mg capsule sig: one (1) capsule po bid (2 times a day). 6. pantoprazole sodium 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:*2* 7. cyanocobalamin 500 mcg tablet sig: two (2) tablet po qd (once a day). disp:*60 tablet(s)* refills:*2* 8. losartan potassium 50 mg tablet sig: one (1) tablet po once a day. 9. furosemide 40 mg tablet sig: one (1) tablet po bid (2 times a day). 10. supplemental oxygen please use supplemental oxygen with exerction. discharge disposition: home with service facility: , discharge diagnosis: upper gi bleed secondary to gastritits secondary diagnoses: dm htn vitmain b12 deficiency discharge condition: good. discharge instructions: please call your primary care physician or return to the hospital if you experience further bleeding, shortness of breath, or any other problems arise. please use supplemental oxygen with exerction. do not take aspirin. followup instructions: 1. provider: , where: phone: date/time: 10:40 2. provider: where: medical specialties phone: date/time: 2:20 3. provider: pain management center where: pain management center date/time: 3:00 4. provider: , m.d. where: center phone: date/time: 1:00 procedure: colonoscopy esophagogastroduodenoscopy [egd] with closed biopsy transfusion of packed cells diagnoses: congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled iron deficiency anemia secondary to blood loss (chronic) other b-complex deficiencies chronic or unspecified gastric ulcer with hemorrhage, without mention of obstruction acute gastritis, with hemorrhage 

Answer: The patient is high likely exposed to