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: history of present illness: this is a 74-year-old gentleman with a history of bleeding, internal hemorrhoids, status post cauterization seven days prior to admission who was started on plavix three days prior to admission. he was admitted to the medical intensive care unit for bright red blood per rectum. the patient said the bleeding started suddenly at 2 o'clock pm on the day of admission with passing large clots and bright red blood per rectum. this was not associated with abdominal pain, nausea, fevers, chills, diarrhea. the patient reports he has bright red blood per rectum on a daily basis, this is basically self-limited. review of systems: the patient complains of severe rectal pain. no complaints of chest pain, dyspnea, short of breath or dysuria. in the emergency department, the patient continued to have profuse bright red blood per rectum and was transfused two units of packed red blood cells. his blood pressure had decreased, systolic blood pressure in the 80's which was corrected by fluid boluses. colonoscopy revealed an actively bleeding internal hemorrhoid which was ligated. past medical history: 1. internal hemorrhoids. 2. diverticula and polyp seen on colonoscopy. 3. chronic renal insufficiency with a baseline creatinine of 2 to 3 thought to be secondary to hypertensive glomerulus scleras. 4. atrial fibrillation. 5. cerebrovascular accident on . 6. obstructive sleep apnea intolerance of cpap. 7. hypercholesterolemia. 8. anemia. allergies: no known drug allergies. medications: 1. plavix 75 mg p.o. q day. 2. diovan 80 mg p.o. q day. 3. allopurinol 100 mg p.o. q day. 4. zantac. 5. lipitor. 6. epoetin 10,000 units q week. 7. iron. social history: the patient lives with his wife. quit smoking several years ago, no alcohol, no intravenous drug use. physical examination: on admission temperature was 97.4, blood pressure 192/47, heart rate 16 sating 100% on two liters nasal cannula. general: alert and oriented times three. some discomfort in the rectal area. head, eyes, ears, nose and throat: pupils are equal, round, and reactive to light and accommodation. extraocular movements intact. dry mucous membranes. neck: supple, no lymphadenopathy or jugular venous distention. pulmonary: clear to auscultation bilaterally. cardiac: bradycardiac. regular. s1 and s2. no murmurs, rubs or gallops. abdomen: obese, nontender. normal active bowel sounds, no organomegaly. extremities: no cyanosis, clubbing or edema. 2+ dorsalis pedis pulses bilaterally. skin: several nevi. cranial nerves 2 through 12 intact. upper and lower extremity strength 5/5 bilaterally. laboratory on admission white cell count 8.3, hemoglobin 9.8, hematocrit 29.7, platelets 157, sodium 142, potassium 4.0. chloride 107, bicarbonate 23, bun 54, creatinine 4.7, glucose 152. ast 15, alt 11, alk phos 86, left ventricular hypertrophy 189, amylase 92, lipase 52, total bilirubin 1.1, magnesium 2.0, phosphorus 4.0, calcium 8.9. urinalysis: positive for moderate blood, 100 protein. hospital course: 1. gastrointestinal bleed. the patient admitted with gastrointestinal bleed from internal hemorrhoids, status post ligation in the emergency department. the patient received a total of 5 units packed red blood cells in the emergency department and medical intensive care unit. by the patient was having only trace bleeding and hematocrit has stabilized. upon transfer to the floor on hematocrit continued to be monitored closely. on the morning of the patient had a drop in hematocrit from 26.9 to 24.6 and received one more unit of packed red blood cells. throughout the remainder of the stay the patient's hematocrit was stable and he did not require further transfusions. 2. change in mental status. in the medical intensive care unit, the patient received ambien, morphine, and tylenol for control of rectal pain. after receiving these medications the patient became confused with orientation only to his self on . it was hypothesized that the morphine was the most likely cause of the patient's change in mental status. the morphine was discontinued and the patient was given tylenol for pain control. other possible causes of change in mental status that were considered included intensive care unit psychosis which was unlikely the short amount of time the patient spent in the unit. in addition, an underlying infection was considered but the patient remained afebrile and without an elevated white blood count. after being taken off the morphine and having his pain controlled only with tylenol the patient's mental status changes resolved. 3. acute on chronic renal failure. the patient was increased in creatinine from baseline. most likely secondary to hyperperfusion in the setting of his gastrointestinal bleed. a renal ultrasound was obtained which did not show any hydronephrosis or post obstructive problems. his creatinine is trending down following intravenous hydration and p.o. intake. 4. atrial fibrillation. the patient is currently off anti-coagulation given his gastrointestinal bleed. at this time, anti-coagulation will be held until the patient follows up with surgery in two weeks. at that time, if the patient is cleared by surgery, neurology and the stroke team recommend long-term anti-coagulation for the patient with a goal inr of 2 to 3. 5. hypertension. the patient's anti-hypertensive was held on admission given his hypotension from the severe gastrointestinal bleed. it was later held due to the patient's chronic renal failure. the patient will be restarted on his today. blood pressure has been trending upward and his creatinine is trending down to baseline. 6. fluid, electrolytes and nutrition. the patient tolerating a house diet. electrolytes have been corrected as needed. 7. prophylaxis. the patient was on unna boots for deep vein thrombosis prophylaxis throughout the hospitalization. he was continued on a bowel regimen to avoid constipation. the patient was continued on ppi. condition on discharge: stable. status: the patient will be discharged to a rehabilitation facility. discharge diagnosis: 1. gastrointestinal bleed from internal hemorrhoids, status post ligation. 2. mental status changes, not otherwise specified, now resolved. 3. paroxysmal atrial fibrillation. 4. hypertension. 5. anemia. 6. chronic renal insufficiency. 7. acute renal insufficiency. discharge medications: 1. colace 100 mg p.o. twice a day. 2. epoetin 10,000 units subcutaneously one time per week. 3. 8.6 mg one tab p.o. twice a day. 4. pantoprazole 40 mg p.o. four times a day. 5. allopurinol 100 mg p.o. q day. 6. valsartan 80 mg p.o. q day. 7. acetaminophen 325 mg one to two tabs p.o. q 4 to 6 hours p.r.n. follow-up: the patient should follow-up with pcp . at earliest convenience. the patient will follow-up with dr. from behavioral neurology on at 10:00. the patient should follow-up with dr. in two weeks. please call to make an appointment. dictated by: medquist36 procedure: ligation of hemorrhoids diagnoses: pure hypercholesterolemia acute posthemorrhagic anemia acute kidney failure, unspecified atrial fibrillation hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease unspecified sleep apnea internal hemorrhoids with other complication 

Answer: The patient is high likely exposed to