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: coffee ground emesis major surgical or invasive procedure: endoscopic gastroduodenoscopy history of present illness: pt states that for the past month she had had a sense of epigastric heaviness and more recently a sense of fatigue. on she attempted to have a bowel movement and after arising from the toilet she got lightheaded, weak and fell to the floor. no loc or head contact. she was taken to were she was noted to have coffee ground emesis, hct=28.5, and ed showed a large gastric ulcer. she received 3 units of prbcs which bumped her hct to 33. her hct remained stable and she was discharged on . on she again had an episode of lightheadedness and weakness and returned to . she again had bloody emesis, hct=26, and a repeat egd w/ epinephine injections x4 that were reported to control the bleeding. she received six units prbcs and had a hct bump to 34.5, protonix iv, lopressor iv for elevated bps. she was also noted to have a new onset a-flutter as well as one bout of tarry black watery diarrhea. she was never in hemodynamic compromise or requiring o2 supplementation. overnight she had recurrence of hematemesis and due to an inadequate supply of 0 negative blood was transferred to . there is a question of a recent h. pylori positive test. no nsaid use. past medical history: 1) htn (dx: 20+ yrs ago) 2) lupus (dx: 20 yrs ago) associated arthritis 3) hypothyroid (s/p surgery yrs ago) 4) glaucoma left eye social history: lives in with son and husband. active physical life -- dances once a week and walks 2 miles daily. no tobacco. no drugs. social drinker in past. family history: nc physical exam: 98.9/98.9, bp 142/80, hr 83 , rr 18, spo2 96%ra gen- pleasant, non-ill appearing f in nad heent- op clear with mmm neck- no jvd, no lad cv- rrr, s1s2, occ ectopy, no m/r/g pul- moves air well, no w/r/r abd- soft, nt, nd, nabs extrm- no c/c/e, warm/dry neuro- a&ox3, no focal cn/motor deficits pertinent results: 03:30pm blood wbc-13.1* rbc-4.33 hgb-13.3 hct-36.9 mcv-85 mch-30.7 mchc-36.0* rdw-13.6 plt ct-281 04:58am blood wbc-8.0 rbc-3.67* hgb-11.2* hct-32.0* mcv-87 mch-30.6 mchc-35.0 rdw-13.8 plt ct-253 06:35am blood wbc-10.6 rbc-4.57 hgb-14.0 hct-40.1 mcv-88 mch-30.7 mchc-34.9 rdw-13.7 plt ct-388 03:30pm blood glucose-76 urean-22* creat-0.7 na-142 k-3.3 cl-103 hco3-29 angap-13 07:00am blood glucose-93 urean-10 creat-0.8 na-137 k-3.8 cl-97 hco3-30* angap-14 brief hospital course: 84 y/o f w/ ugib secondary to gastric ulcer and new onset a-flutter. 1.)ugib: mrs. came in with a known bleeding ulcer and a hematocrit that was still off of her baseline despite transfusion of six units of prbcs at the outside hospital. she underwent an egd that showed gastritis and an ulcer on the lesser curvature that was cauterized with good effect. h. pylori was positive, so clarithromycin/metronidazole/ pantoprazole were started on for a fourteen day course. once this is finished, she will remain on the pantoprazole, but take it once daily. following this, her hematocrit remained stable throughout the rest of her hospital stay, with only one further transfusion performed 4 days prior to discharge. a gastrin level was checked and was still pending at discharge; she was asked to follow-up with her gastroenterologist to follow this value. she has an appointment in eight weeks to repeat the egd for re-assessment and biopsies. she has been advised to avoid nsaid's and asa. 2) htn: she was started on metoprolol for blood pressure control, and as she appeared stable hemodynamically, her lisinopril and felodipine were severally re-added. this provided good blood pressure control, so her aldamet was held, with the understanding that this could be re-started as an outpatient at the discretion of her primary care doctor. 3) atrial flutter: a new finding not previously noted, mrs. was found to be in a-flutter at osh on ecg. she suffered no hemodynamic compromise from the rhythm and was begun on metoprolol at for rate control. she remained stable and eventually converted into a sinus rhythm with occasional atrial ectopy. the plan is for her to follow-up as an outpatient with cardiology, for possible consideration of cardioversion, as it was felt that this decision should wait until she was through the acute course of her gi bleed. she was not anticoagulated given her gi bleed and the risk of re-bleeding. 4) hypothyroid: her levothyroxine was intially continued at her home dose of 50, yet as her tsh value was 4.4, the dose was increased to 100mcg daily. she tolerated the dose increase well with a plan for her to follow-up with her primary care doctor for repeat thyroid function tests in six to eight weeks. 5) lupus: stable and without symptoms obvious symptoms (see below) as an inpatient, she was continued on her home dose of hydroxychloroquine. 6) right ankle swelling: this appeared during the admission. there was no warmth to indicate cellulitis or gout, and there was no fluid to tap for analysis. it was felt this may have represented an aspect of her lupus, and in addition to her hydroxychloroquine, acetaminophen was initiated with good relief of discomfort. leni's were performed and showed no evidence of dvt. medications on admission: --levothyroxine 50 mcg --digoxin 0.125 mg qd --aldomet --lisinopril --calcium channel blocker --hydroxychloroquine discharge medications: 1. clarithromycin 500 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 10 days. 2. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 10 days. 3. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours) for 10 days. 4. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day: to start after patient has received ten days of the same medication/dose twice daily. 5. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 6. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). 7. hydroxychloroquine sulfate 200 mg tablet sig: one (1) tablet po daily (daily). 8. levothyroxine sodium 100 mcg tablet sig: one (1) tablet po daily (daily). 9. felodipine 5 mg tablet sustained release 24hr sig: two (2) tablet sustained release 24hr po daily (daily). 10. aldomet 250 mg tablet sig: two (2) tablet po once a day. discharge disposition: extended care facility: namasket discharge diagnosis: gastric ulcer acute blood loss secondary: 1) htn (dx: 20+ yrs ago) 2) lupus (dx: 20 yrs ago) associated arthritis 3) hypothyroid (s/p surgery yrs ago) 4) glaucoma left eye discharge condition: good, with stable hematocrit and hemodynamics discharge instructions: call your pcp or return to the emergency department for blood in your stool, tarry-black stools, lightheadedness, shortness of breath, chest pain, fevers/chills, or other concerning symptoms. we have held one of your blood pressure medications, aldamet. we recommend that you do not take this medication until you see your primary care physician, whom you can decide whether or not to restart the medication. take your medications as prescribed. follow-up as below. followup instructions: please see your primary care doctor in one to two weeks. call to make an appointment. as above, you will need to discuss restarting your aldamet (blood pressure medication) with him/her. . please see your gi doctor in weeks. ask him/her to follow-up on the results of your gastrin study. . you will need a repeat egd (scope to examine your stomach) in eight weeks. a letter has been to your home to explain this follow-up. the appointment is: provider: , md where: building (/ complex) endoscopy suite phone: date/time: 9:00 provider: suite gi rooms where: gi rooms date/time: 9:00 . you have follow-up with a cardiologist for evaluation of your heart rhythm (atrial flutter): provider: , m.d. where: cardiac services phone: date/time: 10:00 procedure: endoscopic control of gastric or duodenal bleeding transfusion of packed cells diagnoses: systemic lupus erythematosus unspecified essential hypertension acute posthemorrhagic anemia unspecified acquired hypothyroidism atrial flutter chronic or unspecified gastric ulcer with hemorrhage, without mention of obstruction 

Answer: The patient is high likely exposed to