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: melana major surgical or invasive procedure: egd history of present illness: 71m russian speaking man with hyperlipidemia, hypertension, chf, cad, s/p stent to lad in , complete heart block, s/p pacemaker implantation esrd on hd, diverticulosos on coumadin who presented to pcps office with fatigue, doe and intermittent nonexertional nonradiating squeezing cp that resolved with slng and was typical of past angina. patient also reports that he's has ~5 days of black stools, approximately once per day for the past 5 days. he was guaiac positive in the ed and found to have a hct of 17, down from his baseline of 26-30. patient is on asa, plavix, and coumadin. he denies any dysphagia, odynophagia, wretching, etoh intake, nsaid intake, gerd symptoms, excessive warfarin . he is a dialysis patient and had his last dialysis on saturday in , from where he returned 2 days ago. past medical history: cad, s/p stent to the lad on then overlapping des to the lad on hypertension chf- ef 55%, 1+ mr, mild lvh by echo (ef 49% by stress mibi ) diabetes hyperlipidemia heart block s/p pacemaker chronic renal failure on hd q mon, and friday (plan for a transplant in the future) s/p right arm av fistula cellulitis bilateral adrenal adenomas diverticulosis antral polyps cholelithiasis by ct on s/p right cfa pseudoaneurysm repair for wound cellulitis post catheterization social history: restauranteur denies etoh intake, tobacco use or illicit drug use 40 pk-yr history, quit 24 yr ago. family history: negative for coronary artery disease. mother: died of multiple myeloma at age 84. father: died at age 30 as a casualty of war physical exam: vitals - t:97.4 bp:154/58 hr:77 rr:20 02 sat:100ra general: laying in bed, nad skin: warm and well perfused, bilateral le venous stasis changed heent: at/nc, eomi, perrla, anicteric sclera, pale conjunctiva, patent nares, mmm, good dentition, supple neck, no lad, no jvd cardiac: rrr, s1/s2, diastolic murmur at base lung: ctab abdomen: nondistended, +bs, nontender in all quadrants, no rebound/guarding, no hepatosplenomegaly m/s: moving all extremities well, no cyanosis, clubbing or edema, no obvious deformities pulses: 2+ dp pulses bilaterally neuro: cn ii-xii intact pertinent results: cxr line placement: impression: stable cardiac silhouette. satisfactory position of right ij line with no pneumothorax. labs: 02:45pm blood wbc-7.1 rbc-1.82*# hgb-5.8*# hct-17.0*# mcv-93 mch-31.6 mchc-33.9 rdw-15.6* plt ct-240 03:40am blood wbc-9.5 rbc-3.16*# hgb-9.5*# hct-28.0* mcv-89 mch-30.0 mchc-33.9 rdw-16.8* plt ct-208 02:25am blood wbc-9.3 rbc-3.05* hgb-9.3* hct-27.0* mcv-89 mch-30.6 mchc-34.6 rdw-16.7* plt ct-224 08:15am blood hct-27.4* 02:45pm blood pt-28.3* ptt-60.5* inr(pt)-2.9* 02:25am blood pt-16.3* ptt-28.9 inr(pt)-1.5* 02:45pm blood glucose-168* urean-100* creat-6.8* na-136 k-5.0 cl-105 hco3-19* angap-17 02:25am blood glucose-100 urean-59* creat-4.8* na-139 k-4.4 cl-105 hco3-26 angap-12 02:45pm blood ck(cpk)-215* 05:50pm blood ck(cpk)-206* 02:59am blood ck(cpk)-157 02:45pm blood ck-mb-9 ctropnt-0.10* 05:50pm blood ck-mb-9 ctropnt-0.10* 02:59am blood ck-mb-8 ctropnt-0.11* 05:50pm blood calcium-8.8 phos-4.6* mg-3.0* brief hospital course: 71m with cad s/p pci, esrd on hd, chb s/p ppm, with gi bleed, s/p hd and 4u prbcs on . . . gi bleed: he received a total of 9 units of prbcs. his hct remained stable at 27. an egd showed bleeding in the 2nd and 3rd portion of the duodenum. he also had coffee ground emesis in the stomach and a thickened area in the antrum. this was not biopsied because his inr was too elevated. he remained stable with hct of 27. he was continued on his aspirin and plavix given his cardiac stent placed a month ago. however, after discussion with his cardiologist, dr. , it was decided that his coumadin could be discontinued (was on it for aflutter s/p ablation). he was reversed with ffp and vitamin k to bring his inr down to help stop the bleeding. he is scheduled to have another egd on monday to bx the thickened antrum and look for any residual bleeding. . esrd on hd: nephrology was aware and he received dialysis while in house. . cad: no evidence of nstemi with unchanged ekg and negative cardiac enzymes. he was continued on his statin. continued aspirin and plavix as described above. hct goal was 30 given cad. pump: ef55%, held his bb initially given gi bleed and then restarted once stable. diovan restarted. furosemide restarted on discharge. rhythm: complete heart block s/p ppm. . dm2: gave insulin per sliding scale . . after discussion with the patient, the patient's pcp and the micu team, it was decided that he was safe for discharge with close follow up. medications on admission: asa 325 mg 1 tab daily toprol xl 100 daily glyburide 1.25 mg 2 tabs for increased bs (usually 1 time weekly) calcium acetate 667 mg 1 tab in am and 2 tabs in the pm lasix 40 mg 2 tabs lipitor 20 mg 1 tab daily nifedipine 30 mg 1 tab in am and 2 tabs in the pm plavix 75 mg 1 tab daily diovan 80 mg daily lorox 0.77% to the bottom of the feet discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 3. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 4. valsartan 80 mg tablet sig: one (1) tablet po daily (daily). 5. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po twice a day. disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* discharge disposition: home discharge diagnosis: primary diagnosis: gi bleed, acute blood loss anemia . secondary diagnosis: cad s/p stent htn dm2 esrd on hd discharge condition: afebrile, stable vital signs, tolerating pos, ambulating without difficulty. discharge instructions: you came in with a gi bleed and were found to have a hct of 17 which is very low. you were given a total of 7 units of prbc. you had a gi procedure, egd, which showed bleeding in the small bowel. you will require a follow-up egd on monday with dr. . please avoid taking your asa until after the procedure. please return to your regularly scheduled hemodialysis on mondays and fridays. . 1. please take all medication as prescribed. 2. please attempt to make all medical appointments. 3. please return to the emergency room if you have any concerning symptoms. . please follow up with dr. in the next week. followup instructions: please follow up with dr. , your pcp, the next week . his office said to call the schedule the appointment. . provider: suite gi rooms date/time: 8:00 provider: , md phone: date/time: 8:00 procedure: other endoscopy of small intestine hemodialysis injection or infusion of other therapeutic or prophylactic substance transfusion of packed cells transfusion of other serum diagnoses: end stage renal disease acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled aortocoronary bypass status hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other and unspecified hyperlipidemia atrioventricular block, complete other and unspecified angina pectoris unspecified sleep apnea cardiac pacemaker in situ hemorrhage of gastrointestinal tract, unspecified diastolic heart failure, unspecified 

Answer: The patient is high likely exposed to