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 71-year-old woman with a chief complaint of hematemesis. the patient with a history of chronic obstructive pulmonary disease and peptic ulcer disease 40 years ago; who, on the morning of admission, felt nauseous upon waking up. improved with eating breakfast; however, around noon the patient felt nauseated and weak. at 12:10 p.m. the patient suddenly vomited a large amount of bright red blood. she has had no recent illness. no chest pain. status post vomiting, she started feeling weak and short of breath. she was brought into emergency department. she had melanotic stool in the emergency department. on arrival to the emergency department, her temperature was 98.1, blood pressure was 126/44, heart rate was 99, respiratory rate was 28, and oxygen saturation was 100% on room air. nasogastric tube suctioning showed coffee-grounds emesis. she had been prevacid orally and then given intravenous famotidine. subsequently, several hours later, the patient was given intravenous protonix 40 mg. past medical history: 1. she had peptic ulcer disease 40 years ago. 2. chronic back pain (in , she had a spinal cord stimulator placed). 3. chronic obstructive pulmonary disease (on home oxygen at 2 liters at baseline). 4. myocardial infarction in and ; status post coronary artery bypass graft in and . 5. hypertension. 6. hypercholesterolemia. 7. she had an aortobifemoral bypass and a right renal artery bypass in . 8. she is status post cholecystectomy. 9. status post appendectomy. 10. she has congestive heart failure (with an ejection fraction of 30% in ). medications on admission: (her medications on admission included) 1. azmacort 4 puffs inhaled twice per day. 2. aspirin 81 mg p.o. once per day. 3. norvasc. 4. albuterol 2 puffs inhaled twice per day. 5. 60 mg p.o. once per day. 6. lisinopril 5 mg p.o. once per day. 7. soma 350 mg p.o. four times per day as needed (for pain). 8. darvocet one tablet p.o. four times per day as needed. 9. colace. 10. famotidine 20 mg p.o. q.h.s. 11. prozac 20 mg p.o. once per day. 12. lasix 20 mg p.o. once per day. 13. atrovent 2 puffs inhaled four times per day. 14. sublingual nitroglycerin as needed. allergies: allergy to ativan (she gets anaphylaxis) and morphine (she gets nausea). she also has an allergy to valium, haldol, tape, sulfa, and codeine. social history: she lives alone. her nephew (telephone number ) is her health care proxy. she is a 100-pack-year smoker; one quarter of a pack per day currently. she is do not resuscitate/do not intubate. review of systems: on review of systems, she was fully independent at baseline. she drives and goes grocery shopping by herself without difficulty. she gets chest pressure once every few months and takes sublingual nitroglycerin as needed. physical examination on presentation: on examination, her temperature was 98.1, blood pressure was 126/44, and heart rate was in the 80s. in general, she was a thin elderly woman in no apparent distress. she appeared slightly uncomfortable and anxious. head, eyes, ears, nose, and throat examination revealed the oropharynx was dry. no blood was visible. chest examination revealed breath sounds were distant. she had no wheezes, rhonchi, or rales. cardiovascular examination revealed a regular rate and rhythm. normal first heart sounds and second heart sounds. no murmurs. the abdomen was soft, nontender, and nondistended. positive bowel sounds. extremities were warm and well perfused. no edema. pertinent laboratory values on presentation: laboratories on admission revealed her white blood cell count was 8.3, hematocrit was 27.1 (repeat hematocrit was 25.7 three hours later), and platelets were 250. differential with 71% neutrophils, 24% lymphocytes, and 4% monocytes. her chemistry-7 was unremarkable other than an elevated blood urea nitrogen of 61 and a creatinine of 0.9. creatine kinase was 79. troponin was less than 0.3. pertinent radiology/imaging: a chest x-ray showed no infiltrates. no pneumothorax. hospital course by issue/system: the patient was admitted to the medical intensive care unit from to . 1. gastrointestinal issues: on the evening of admission, she had emergent esophagogastroduodenoscopy which showed an active pumping arterial bleeding vessel in the fundus 5 cm distal to the gastroesophageal junction. epinephrine and electrocautery were attempted to stop the bleed, but this failed. she was then subsequently sent to interventional radiology who injected the celiac axis to localize the bleed, but no bleed was found. they attempted to embolize the left gastric artery but failed secondary to its tortuosity. the bleed appeared to have stopped. in the medical intensive care unit she received 48 hours of octreotide, given intravenous protonix 40 mg twice per day (which was changed to 40 mg p.o. twice per day), and her diet was advanced to clears. she had received 4 units of packed red blood cells and one bag of platelets while on the unit. the platelets were given because the patient had been on aspirin, but she was not thrombocytopenic. she was then transferred out to the floor after her hematocrit had been stable on . her hematocrit was 36 status post transfusion and remained at this level over a 72-hour period. her diet was continually advanced, and she had brown stools by the time she left the hospital. she was to follow up with dr. on for a repeat esophagogastroduodenoscopy. 2. chronic obstructive pulmonary disease issues: she was stable on home oxygen. she was continued on her inhalers. 3. coronary artery disease issues: the patient was ruled out for a myocardial infarction given her dyspnea. her antihypertensives were held given the possibility of becoming hypotensive, and her aspirin was also discontinued given her risk of bleeding. she was to follow up with her primary care physician; at which point he will decide on restarting her antihypertensives. she also has congestive heart failure which was stable. previously on lasix 20 mg p.o. once per day; but this has also been held and was to be restarted by her primary care physician. 4. back pain issues: she has chronic back pain. she was to continue on her home medications including her soma and darvocet. 5. anemia issues: the patient was worked up as an outpatient including a bone marrow biopsy which was normal. her hematocrit was stable for 72 hours status post transfusion on . 6. code status: her code status is do not resuscitate/do not intubate. discharge status: the patient was discharged to home with for blood pressure monitoring. discharge diagnoses: (her discharge diagnoses included) 1. upper gastrointestinal bleed. 2. status post transfusion of four units of packed red blood cells and one bag of platelets. 3. gastric ulcer with arterial bleed. 4. hypertension. 5. coronary artery disease. 6. peptic ulcer disease. 7. chronic obstructive pulmonary disease. 8. hypercholesterolemia. 9. congestive heart failure (which is stable). 10. anemia. major surgical/invasive procedures: 1. esophagogastroduodenoscopy with electrocautery. 2. epinephrine injection. 3. interventional radiology embolectomy attempt. discharge instructions/followup: 1. the patient was discharged to home with to continue blood pressure monitoring. 2. the patient was advised to return to the hospital right away with any signs of bleeding; including bright red blood per rectum, vomiting, coffee-grounds emesis, black stools, red stools, lightheadedness, chest pain, shortness of breath, or dizziness. 3. the patient was to stop aspirin and all nonsteroidal antiinflammatory drugs. 4. the patient was to hold her blood pressure medications for now including her norvasc and lisinopril and to be restarted by dr. . the patient was also to hold her lasix; also to be restarted by dr. . 5. the patient had a follow-up appointment with dr. on at 12 noon. 6. the patient had a follow-up appointment with dr. in gastroenterology for a repeat esophagogastroduodenoscopy to follow up her gastric ulcer on . 7. helicobacter pylori was added to her laboratories on the day of discharge; which were still pending. medications on discharge: (her discharge medications included) 1. atrovent 2 puffs inhaled twice per day. 2. azmacort 4 puffs inhaled twice per day. 3. albuterol 2 puffs inhaled twice per day and q.4-6h. as needed. 4. protonix 40 mg p.o. q.12h. 5. soma 350 mg p.o. four times per day as needed. 6. fluoxetine 20 mg p.o. once per day. 7. nitroglycerin 0.4-mg tablet p.o. as needed. 8. colace 100 mg p.o. twice per day. 9. 60 mg p.o. once per day. 10. darvocet one tablet p.o. four times per day as needed (for pain). , m.d. dictated by: medquist36 procedure: endoscopic control of gastric or duodenal bleeding arteriography of other intra-abdominal arteries other irrigation of (naso-)gastric tube diagnoses: acute gastric ulcer with hemorrhage, without mention of obstruction tobacco use disorder congestive heart failure, unspecified unspecified essential hypertension acute posthemorrhagic anemia chronic airway obstruction, not elsewhere classified aortocoronary bypass status lumbago 

Answer: The patient is high likely exposed to