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: penicillins attending: chief complaint: bleeding from mouth major surgical or invasive procedure: egd, ir embolization history of present illness: mrs is a pleasant 86 yo woman with dementia, hx cabg, htn, hyperthyroidism, dm, tias, who presented to after having been found by her daughter covered in blood, with blood in her mouth, characterized as approximately 1 l of blood lost. daughter states that she left to do an errand and returned to find her mother confused and bleeding from her mouth. she has no known history of liver disease or gib. she was transferred by ems to an outside hospital where crit was 24.7 she was started on vasopressin for sbp of 94, protonix and given 1 unit of prbcs, 2 l of fluid, transferred to for urgent egd. in our ed, on arrival her maps were in the 50s-60s, however improved to 65-75 and pressors were weaned. she was febrile to 100.7 rectal, exam was notable for petichae in sublingual region, blood crusting around mouth. echo showed appropriate resp variation in ivc, fast was negative. a left subclavian was placed and cvp was measured at 5-6. crit was 23.5, inr was 1.4, lactate 3.6 pt had a leukocytosis to 16.3. she was 2 u prbcs were ordered, 1 was given in the ed. cxr unremarkable, inf q waves on ekg. she was producing urine, having an output of 50 ccs in last hr prior to icu transfer. she was given zosyn and vanco for fever and continued on a ppi gtt. a left subclavian was placed and she was transferred with 2 pivs. cxr showed no acute process. . on the floor, pt is conversant but confused. denies shortness of breath, cp, discomfort. past medical history: diabetes cad, s/p 4 v cabg mi a fib arthritis colitis dementia goiter, hyperthyroid, pt refused surgery in the past htn tia pernicious anemia appendectomy, cholecystectomy social history: lives with daughter, is functional with some supervision. no etoh, tob, illicits. family history: sister with brain cancer physical exam: on admission: vitals: t:96 bp:120/99 p:105 r: 20 o2: 100% ra general: interactive, responsive, no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad, large neck mass lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: irregular rhythym, tachycardic, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, mildly distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: foley in place ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: unable to assess, sedated pertinent results: on admission: . 07:15pm blood wbc-16.3* rbc-2.70* hgb-7.6* hct-23.5* mcv-87 mch-28.0 mchc-32.2 rdw-12.8 plt ct-295 07:15pm blood pt-15.5* ptt-27.7 inr(pt)-1.4* 02:14am blood albumin-2.7* calcium-6.7* phos-5.2* mg-1.8 07:02am blood type-art rates-14/ tidal v-450 peep-5 fio2-40 po2-191* pco2-31* ph-7.44 caltco2-22 base xs--1 -assist/con intubat-intubated . urine cx and blood cx: no growth . cxr no acute cardiopulmonary abnormality. . cxr endotracheal tube ends in standard placement at the thoracic inlet and the trachea is shifted substantially to the right and prior to intubation, one can see is severely narrowed, by a presumed huge left-sided goiter or a mammoth arterial aneurysm. . tip of the left subclavian line ends at the origin of the svc. moderate cardiomegaly is stable. lungs grossly clear. no pneumothorax or pleural effusion. descending thoracic aorta is tortuous and may be mildly dilated. stomach is moderately distended with gas. . : transcatheter embolization findings: 1. active extravasation from the branch of the gda into the proximal duodenum. 2. gelfoam slurry embolization and 2 cm x 3 mm coil embolization of the branch of sma with no residual active extravasation. 3. atherosclerotic aorta and mesenteric arteries. impression: successful embolization of the active bleeding focus from gda with no residual active extravasation post-procedure. . r le u/s of catheterization site impression: no evidence of a hematoma and no pseudoaneurysm identified. . : lue u/s . impression: 1. thrombus seen in one of the superficial veins, the left cephalic vein. no evidence of deep vein thrombosis in the left arm. 2. incidental left thyroid nodule. . discharge 06:13am blood wbc-7.1 rbc-2.79* hgb-8.3* hct-24.1* mcv-86 mch-29.7 mchc-34.4 rdw-14.2 plt ct-149* 06:13am blood glucose-112* urean-10 creat-0.6 na-137 k-3.0* cl-104 hco3-26 angap-10 06:13am blood calcium-8.1* phos-2.0* mg-1.8 brief hospital course: pleasant 86 yo female presenting from osh with hypotension, bleeding from mouth concerning for ugib, found to have rapid arterial bleed in the duodenal bulb, now s/p ir embolization. . # ugib/dieulafoy's lesion: scoped on arrival to the unit, found to have bleeding ulcer in the duodenal bulb which was bleeding rapidly and unable to be intervened upon. unclear cause of ulcer, pt had been on naproxen/aspirin but had not been taking recently, no hx of h. pylori. unstable with pressures in the 90s and tachycardia to the 120s, repeat crit of 16.4 after transfusion of 2 units, therefore massive transfusion protocol was initiated pt went for ir embolization, which was successful and crits stabilized thereafter. in total, she was transfused 7 units. dnr/dni status was reversed for the procedure. procedure was complicated by groin hematoma. us showed no evidence of hematoma or aneurysm. on the floor pt remained hemodynamically stable and hematocrit was stable at 24-25. she was started on famotidine for gi prophylaxis, as ppis increase risk of pna, specifically aspiration pna. her asa was restarted as the literature indicates those pt's with true cad, had lower all cause mortality and fewer mi's when aspirin was continued and a nonsignificant increased amount of bleeding from pud. her dose was decreased from 325 to 81mg because women do not confer any survival benefit from high dose asa. . # fever: pt had one fever in the ed, with no clear source. per family, pt was asymptomatic prior to arrival. abx were held and she had no further fevers throughout the admission. cxs did not speciate. . # hx cad: s/p cabg, no recent cp or evidence of active coronary disease. her home aspirin, atenolol, amlodipine, and lisinopril were held in the setting of active gi bleed. she was restarted on home medications with the exception of amlodine because she remained normotensive without it. as mentioned above, her asa was decreased to 81mg. . # elevated pth in setting of hypocalcemia: in icu attributed to citrate toxicity from blood transfusions, pth was sent and found to be elevated at 125. of note, pt's was hyperphosphatemic at the time which can cause elevated pth secretion. furthermore, a free calcium was measured within normal limits and albumin was low indicating that total ca decreased due to hypoalbuminemia. . # dementia: home namenda and aricept were held given pt unable to take pos, restarted when regular diet resumed. . # hyperthyroidism: methimazole was held given pt unable to take pos, restarted when regular diet resumed. of note, report from lue u/s notes a thyroid nodule, and it is unclear if this was present earlier. . # superficial vein clot: last day, had swelling in left arm, nontender. us revealed cephalic vein clot, but no dvt. . # dm: maintained on iss . . dnr/dni . transitional: - follow up incidental solid thyroid nodule in l thyroid. - follow up ca+ and high pth as outpt for furtherwork up if indicated medications on admission: aspirin 325 namenda 10 aricept 10 q am atenolol 50 mg amlodipine 5 mg lisinopril 10 mg q am janumet 50/500 1 q am methimazole 10 mg daily discharge medications: 1. outpatient lab work cbc please fax to dr. office at ( please have labs drawn on 2. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). disp:*30 tablet, chewable(s)* refills:*2* 3. memantine 10 mg tablet sig: one (1) tablet po bid (2 times a day). 4. donepezil 10 mg tablet sig: one (1) tablet po hs (at bedtime). 5. atenolol 50 mg tablet sig: one (1) tablet po daily (daily). 6. methimazole 10 mg tablet sig: one (1) tablet po daily (daily). 7. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 8. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 9. janumet 50-500 mg tablet sig: one (1) tablet po qam. discharge disposition: home with service facility: discharge diagnosis: bleeding dieulafoy's lesion hypovolemic shock atrial fibrillation alzheimer's dementia discharge condition: mental status: confused - always. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: dear mrs., it was a pleasure taking care of you. you were admitted to the hospital for a gastrointestinal bleed. we performed an exam called an upper endoscopy and the bleeding source was identified in your small intestine. a special procedure was performed called an arterial embolization and the bleeding stopped. when you were bleeding, your blood pressure dropped and your blood counts were very low. because of this, you were admitted to the intensive care unit and you required multiple blood transfusions and intravenous fluids. the bleeding has now stopped and we believe that you are safe to go home. . we have made the following changes to your home medications: 1. start famotidine 20mg tablet by mouth twice daily 2. change: aspirin from 325 mg daily to 81mg daily 3. stop: amlodipine 5 mg daily 4. stop: naproxen 500 mg tablet twice daily. please avoid all nsaid medications (includes ibuprofen) . we have arranged a follow up appointment for you with your pcp, information for this appointment is below. prior to following up with your primary care doctor, we would like you to get lab work to make sure your blood counts are stable. please have this lab work done 2 days prior to your appointment. followup instructions: name: , address: ,, , phone: appointment: friday 10:00am procedure: arterial catheterization endoscopic control of gastric or duodenal bleeding arteriography of other intra-abdominal arteries transcatheter embolization for gastric or duodenal bleeding diagnoses: hypocalcemia unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status hematoma complicating a procedure other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other specified cardiac dysrhythmias other shock without mention of trauma personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits do not resuscitate status alzheimer's disease dementia in conditions classified elsewhere without behavioral disturbance toxic diffuse goiter without mention of thyrotoxic crisis or storm accidents occurring in residential institution unspecified sedatives and hypnotics causing adverse effects in therapeutic use dieulafoy lesion (hemorrhagic) of stomach and duodenum arthropathy, unspecified, site unspecified pernicious anemia 

Answer: The patient is high likely exposed to