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: naprosyn attending: chief complaint: gi bleed major surgical or invasive procedure: 1. mesenteric angiography. 2. enteroscopy w/ cautery and tattoo. history of present illness: this a 71 year old female with multiple medical problems including recurrent gi bleed, coronary artery disease, hypertension, diabetes mellitus type 2, gastritis, hypercholesterolemia, chronic renal insufficiency and depression who presents to the ed after finding her blood pressure to be 84/54 at home on the day of admission. patient reports having worsening dyspnea on exertion, dark stools, dizziness with standing and chest pressure with walking x 3-4 days. patient has a history of upper gi bleed secondary to gastritis () and a negative workup for a duodenal neuro-endocrine tumor. most recent hospitalization for bleeding was secondary to small bowel avms found on egd. denies changes in diet, fever/chills, abdominal pain, recent alcohol consumption, nausea/vomitting or recent trauma. patient has been taking a baby asa daily and iron pills three times daily. . in the emergency room, the patient was found to have a hct of 15.6 and hr or 61. she received intravenous fluids and 40 mg of intravenous protonix. a nasogastric lavage was performed which did not reveal an active bleed but also failed to produce bile. patient was tranfused two units of prbcs and her hct subsequently rose to 23. gi was consulted and the patient was admitted to medicine for further observation. past medical history: 1. gastritis 2. history of upper gastrointestinal bleed 3. duodenal neural endocrine tumor, negative workup; 4. coronary artery disease, status post percutaneous transluminal coronary angioplasty in 5. hypertension 6. hypercholesterolemia 7. type 2 diabetes 8. chronic renal insufficiency, baseline 1.5 to 1.7 9. osteoarthritis 10. history of sarcoid, untreated 11. history of migraines 12. status post appendectomy 13. total abdominal hysterectomy/bilateral salpingo-oophorectomy 14. status post parathyroid adenoma resection 15. status post left wrist fusion 16. status post small bowel resection in 17. history of small bowel bleed, s/p electrocauterization of avms `04 18. history of hospitalization for intermittent small bowel obstruction social history: former smoker, quit greater than 30 years ago. alcohol use, occasionally. family history: non-contributory physical exam: vital signs on admission afebrile, heart rate 68, pressure 155/64, breathing at 15, % on room air. general: alert and oriented, pleasant, no dyspnea and no acute distress. head, eyes, ears, nose and throat, moist mucous membranes,oropharynx clear. lungs clear to auscultation bilaterally. cardiovascular, regular rate with a ii/vi systolic ejection murmur at base radiating to carotids. no carotid bruits auscultated. no jugulovenous pressure. abdominal examination, soft, nontender,nondistended. hypoactive bowel sounds. extremities, no cyanosis, clubbing or edema. alert and oriented times three. no cranial nerve deficits. pertinent results: 02:30am blood wbc-4.3 rbc-1.58*# hgb-4.6*# hct-15.6*# mcv-99*# mch-29.4# mchc-29.7* rdw-21.3* plt ct-208 02:30am blood neuts-76.5* bands-0 lymphs-17.1* monos-5.9 eos-0.4 baso-0.2 02:30am blood hypochr-3+ anisocy-2+ poiklo-1+ macrocy-3+ microcy-normal polychr-1+ schisto-1+ stipple-1+ tear dr1+ 02:30am blood pt-12.6 ptt-24.3 inr(pt)-1.0 02:30am blood glucose-192* urean-91* creat-2.5* na-138 k-4.1 cl-103 hco3-24 angap-15 02:30am blood alt-12 ast-42* ld(ldh)-414* ck(cpk)-51 alkphos-53 amylase-121* totbili-0.3 02:30am blood lipase-171* 02:30am blood ck-mb-notdone ctropnt-<0.01 02:30am blood albumin-3.5 calcium-9.5 phos-3.2 mg-2.2 cholest-113 02:30am blood vitb12-204* folate-18.8 02:30am blood triglyc-191* hdl-28 chol/hd-4.0 ldlcalc-47 02:30am blood tsh-2.1 03:55am urine color-straw appear-clear sp -1.009 03:55am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-5.0 leuks-neg . ekg sinus rhythm, without diagnostic abnormality. compared to the previous tracing of t wave inversions are no longer present. intervals axes rate pr qrs qt/qtc p qrs t 68 176 102 428/444.85 66 -1 95 . c1894 int.shth not/guid,ep,nonlaser 7:12 am reason: embolize site of ooze in proximal jejenum. impression: selective arteriography of the superior mesenteric artery and jejunal branches demonstrated no evidence of arteriovenous malformation or active hemorrhage. . echo the left atrium is mildly dilated. there is severe symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef 60%). right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated. the ascending aorta is mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. the left ventricular inflow pattern suggests impaired relaxation. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. brief hospital course: a/p: 71 year old female with multiple medical problems who presented with gi bleed. 1. gib: a push enteroscopy was performed that revealed melena in the duodenum and fresh blood in the proximal jejunum 80-90 cm from teeth. copious irrigation and epinephrine injection failed to halt the bleeding. on the floor her hct dropped to 16 from 23 and the pt became tachycardic, so she was transferred to the micu. . in the micu, patient received 4u and went from hct of ~15 to low 30s. she received 1 more unit given cardiac status to bring hct>30. upon transfer to micu ir consulted for embolization, however pt was unstable with mi. cardiology saw patient on felt ces were trending downward and recommended ir embolization to stop bleed in proximal jejunum. patient was subsequently transferred to the medicine floor. ir was unable to embolize the source of bleed and so patient underwent repeat endoscopy with successful cauterization of the site of bleed. the site was also tattooed. patient received an additional unit of prbcs on the floor and her hematocrit remained stable and she also was continued on protonix . . 2. nstemi- she developed chest pain and ekg showed st depression in v4-v6. cardiac troponin peaked at 2.5. nstemi was likely secdonary to demand ischemia with tachycardia in setting of her gi bleed. she was started on bb. plaxix and asapirin were held given history of gi bleed. cardiology saw patient on felt ces were trending downward and recommended ir embolization to stop bleed in proximal jejunum. a repeat echo on was mainly unchanged aside from increased left ventricular hypertrophy. patient had remained chest pain free from the time of tranfer from the micu to the day of discharge. . 3.htn- on the floor, blood pressure was not as well controlled off nitro drip and beta blocker. patient was transitioned from po nitrates and hydralazine to beta blocker and . . 4. acute on cri- cr 2.5 on admission from baseline cr 1.6-1.9. creaine was within baseline at 1.7 at time of discharge. . 5. hypernatremia- was thought to be likely secondary to normal saline boluses and free water loss. po intake was encouraged was resolved by time of discharge. . 6. anemia- patient was found to have iron deficiency anemia and vitamin b12 deficient. patient was started on vitamin b12 1000mcg oral supplementation qd. 6.ppx-pneumoboots, ppi . 7.code- full medications on admission: 1) apirin 81mg qd 2) lipitor 10mg qd 3) 60mg 4) celexa 40mg qd 5) clonidine 200mcg 6) cozaar 50mg qd 7) feso4 300mg tid 8) flonase 50mcg one spray each nostril 9) lasix 40mg qam 10) glipizide 5mg tid 11) hydralazine 50mg 1.5 tabs qid 12) lasix 20mg qhs 13) nitrostat 0.3mg as needed 14) norvasc 10mg qd 15) protonix 40mg discharge medications: 1. losartan potassium 50 mg tablet sig: one (1) tablet po daily (daily). 2. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po tid w/meals (3 times a day with meals). disp:*120 tablet, chewable(s)* refills:*2* 3. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po once a day. disp:*120 tablet(s)* refills:*2* 4. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 5. lipitor 10 mg tablet sig: one (1) tablet po once a day. 6. glipizide 10 mg tab, sust release osmotic push sig: one (1) tab, sust release osmotic push po once a day. disp:*30 tab, sust release osmotic push(s)* refills:*2* 7. atenolol 25 mg tablet sig: three (3) tablet po once a day. disp:*120 tablet(s)* refills:*2* 8. fe-tabs 325 (65) mg tablet sig: one (1) tablet po once a day. 9. citalopram hydrobromide 40 mg tablet sig: one (1) tablet po once a day. disp:*60 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: principal: 1. gastrointestinal bleed. 2. non-st elevation myocardial infarcation. 3. acute renal failure. 4. blood loss anemia. 5. left lower lobe pneumonia. 6. vitamin b12 deficiency. secondary: 1. chronic renal insufficiency. 2. hypertension. 3. sarcoidosis. 4. hypercholesterolemia. 5. osteoarthritis. 6. migraines. 7. upper gi bleed. 8. duodenal neuroendocrine tumor. 9. cad - angioplasty lcx . 10. diabetes mellitus type ii. 11. iron deficiency anemia. 13. s/p parathryoid adenoma resection. 14. s/p appendectomy. 15. s/p small bowel resection. 16. s/p tah-bso. discharge condition: good discharge instructions: please take the medications listed below until you follow-up with your primary care physician. do not resume your outpatient medications unless they are listed below: *1) celexa (citalopram hydrobromide) 40 mg one tablet by mouth daily 2) losartan potassium (cozaar) 50 mg one tablet by mouth daily *3) calcium carbonate 500 mg chewable one (1) tablet chewable three times daily w/meals *4) cholecalciferol (vitamin d3) 400 unit two tablets by motuh daily *5) pantoprazole sodium (protonix) 40 mg delayed release one (1) tablet by mouth daily 6) lipitor 10 mg one (1) tablet by mouth daily *7) glipizide 10 mg, sust release osmotic push one (1) tab by mouth daily *8) atenolol 25 mg three (3) tablet all together by mouth daily 9) fe-tabs (iron) 325 (65) mg one (1) tablet by mouth daily *signify new doses for medications and prescriptions attached to this discharge summary please call your pcp or return to the emergency room if you experience chest pain, nausea or vomitting, shortness of breath or any othter worrying symptoms. followup instructions: provider: , md where: phone: date/time:tues 9:00am provider: , md gastroenterologist where: suite 8e phone:= date/time: 1:15pm provider: , md cardiology where: cardiology phone: date/time: 10:30am procedure: other endoscopy of small intestine control of hemorrhage, not otherwise specified arteriography of other intra-abdominal arteries transfusion of packed cells diagnoses: pneumonia, organism unspecified subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery esophageal reflux pure hypercholesterolemia acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified sarcoidosis percutaneous transluminal coronary angioplasty status other and unspecified angina pectoris hemorrhage of gastrointestinal tract, unspecified hyperosmolality and/or hypernatremia 

Answer: The patient is high likely exposed to