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: no known allergies / adverse drug reactions attending: chief complaint: bright red blood per rectum major surgical or invasive procedure: none history of present illness: ms. is a 94 with history of htn, hld, diastolic chf (last ef 55% in ), atrial fibrillation on coumadin s/p cardioversion x2, most recently in , ibs with intermittent rectal bleeding, osteoarthritis, who is presenting with bright red blood per rectum. the patient and patient's son report that the night prior to admission, the patient had an episode of brbpr. denies any associated abdominal pain. has never had this happen to her in the past. she reports that she was trying to pass gas and when she did, there ended up being blood all over the bathroom. as per the patient's son, he reports that there were about ten drops of blood in the toilet bowl. she reports that these episodes happened througout the night, at one hour intervals. she often has frequent episodes of stool at her baseline because of her ibs; intermittent diarrhea and constipation type. as per report, however, the patient reports having crampy abdominal pain associated with her frequent bowel movements overnight, with tenesmus. . of note, the patient has been on coumadin since for atrial fibrillation. she has her inr checked once every two weeks; denies any new medications. denies any fevers/chills. reports some nausea, but has a history of schatkzi's ring s/p esophageal dilation. reports some dizziness and lightheadedness, but reports that she has history of vertigo; not sure if dizziness was consistent with past vertigo. denies any chest pain, trouble breathing, shortness of breath, no vomiting. last colonoscopy in system in ; normal. . in the ed, initial vs were: 97.5 70 148/63 22 99%. 2 brbpr in the ed. she was given 2 units of ffp. ekg was unchanged. hct has remained stable. she was subsequently transferred to micu. the patient has two peripherals and is type and crossed for 2 units. . on arrival to the unit, vital 98.4 96 132/81 18 99%ra. the patient reports feeling well. denying any n/v/d, no abdominal pain, no rectal pain. no weakness, lightheadedness or dizziness. past medical history: afib on coumadin prior mi --declined statins bppv venous stasis irritable bowel syndrome s/p cataract surgery, bilaterally s/p tah pelvic prolapse shatzki ring social history: she lives with her son. she is able to do many of her adl's at her home. she has 4 grown children, whom she is close with. -tobacco history: denies -etoh: denies -illicit drugs: denies family history: great-granddaughter with "missing left ventricle at birth, born 2lbs" no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: admission physical exam: vitals: 95.5 163 78 19 95% on ra general: alert, oriented, nad, pleasant elderly woman, laying comfortably in bed heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp elevated to angle of mandible cv: regular rate and rhythm, normal s1 + s2, loud p2, no murmurs, rubs, gallops appreciated lungs: bibasilar crackles, good air movement, no wheezes/rhonchi abdomen: + bs, slight lower abdominal tenderness, soft, nondistended ext: warm, well perfused, 2+ pulses, 2+ pitting le edema b/l discharge physical exam: general: pleasant, oriented, nad, elderly woman, laying comfortably in bed heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp elevated to the jaw cv: bradycardic and regular rhythm, loud p2, no murmurs, rubs, or gallops appreciated lungs: bibasilar crackles, good air movement, no wheezes/rhonchi abdomen: + bs, soft, nontender, nondistended, no masses appreciated ext: warm, well perfused, 2+ pitting le edema b/l neuro: oriented x3, appropriate, moving all 4 extremities. pertinent results: labs: admission labs: 12:25pm blood wbc-7.5 rbc-3.91* hgb-11.4* hct-36.0 mcv-92 mch-29.2 mchc-31.8 rdw-14.2 plt ct-342 12:25pm blood neuts-67.5 lymphs-22.9 monos-6.0 eos-2.7 baso-1.0 12:25pm blood pt-21.6* ptt-39.0* inr(pt)-2.1* 12:25pm blood glucose-80 urean-27* creat-1.1 na-141 k-4.7 cl-106 hco3-27 angap-13 08:23pm blood calcium-9.0 phos-2.8 mg-1.9 discharge labs: 07:40am blood wbc-9.6 rbc-3.40* hgb-10.1* hct-31.2* mcv-92 mch-29.6 mchc-32.3 rdw-14.5 plt ct-280 07:40am blood pt-13.5* ptt-31.3 inr(pt)-1.3* imaging: cxr comparison: . impression: 1. cardiomegaly and minimal pulmonary vascular congestion. blunting of the right costophrenic angle may be due to overlying soft tissue, although a trace effusion cannot be excluded. 2. hiatal hernia. sigmoidoscopy diverticulosis of the sigmoid colon grade 1 internal hemorrhoids otherwise normal sigmoidoscopy to splenic flexure brief hospital course: ms. is a year old female with history of hypertension, diastolic heart failure (chf, last ef 55% in ), atrial fibrillation on coumadin status post cardioversion x2, most recently in , irritable bowel syndrome (ibs) with intermittent rectal bleeding, osteoarthritis, who is presenting with bright red blood per rectum (brbpr). active issues by problem: # lower gi bleed: initially admitted to the icu for monitoring. gi was consulted and they recommended a ct scan of the abdomen and an inpatient colonoscopy. however, the patient declined both of these studies since her bleeding resolved and she was claustophobic. also, she reported that she already had 2 colonoscopies which she did not think had ever been helpful. her hematocrit dropped from 36 to 30 initially, however, it then remained stable at 30 and she did not have further bloody bowel movements while in the icu. she did not require blood transfusions since she was not symptomatic from blood loss. she did agree to have a flexible sigmoidoscopy which showed diverticulosis and grade 1 internal hemorrhoids but no active bleeding. given these findings, she most likely had a self-resolving diverticular bleed. as these are prone to recur, the risk of continuing coumadin therapy did not seem worth the benefit, so she was told to stop this on discharge. will defer to her pcp and cardiologist for further management and discussion of risk vs benefit of coumadin therapy. # atrial fibrillation: status post cardioversion in with chads score of 3, on coumadin at presentation. she was given 2 units ffp to reverse here inr, and her aspirin and warfarin were held due to active bleeding. she was continued on her home amiodarone. she was not restarted on her aspirin or warfarin at discharge given her recent bleed, however will defer to outpatient pcp and cardiologist for further management. chronic issues by problem: # diastolic heart failure (dchf): the patient has a history of diastolic chf. not on daily diueretic regimen, but takes prn. her diuretics and metoprolol were held due to potential gi bleed and hypovolemia. transitional issues: - anticoagulation: will need to determine if she should restart warfarin and/or aspirin medications on admission: lorazepam 0.5 mg prn metoprolol succinate 50 mg warfarin 2.0 mg daily, except tues/friday 1 mg) amiodarone 200 mg qday fish oil prilosec 20 mg daily mvi asa 81 furosemide 20 mg prn for leg swelling discharge medications: 1. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 2. multivitamin tablet sig: one (1) tablet po once a day. 3. lorazepam 0.5 mg tablet sig: one (1) tablet po twice a day as needed for anxiety. 4. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). 5. metoprolol succinate 25 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po once a day. 6. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). discharge disposition: home with service facility: homecare discharge diagnosis: primary diagnosis lower gi bleed discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: dear ms. , you were admitted to the hospital because you were having bleeding in your stool. you were monitored in the icu to check the level of your blood every few hours. you had an initial drop, however, it stabilized and you did not have any more bleeding. the gi specialits saw you and they recommended a ct scan and a colonoscopy to try to look for the source of bleeding. however, you chose not to undergo these tests because you had already improved. they did do a test called a sigmoidoscopy to look at the last half of your colon, and they saw diverticula (outpouchings of colon) and internal hemorrhoids but no bleeding. because your bleeding stopped, it was decided that you were safe to go home. the following changes were made to your medications: stop warfarin stop aspirin both these medications are being stopped because they put you at higher risk for bleeding. please do not re-start these medications or take ibuprofen unless your doctor says to do so. it is very important that you keep all of the follow-up appointments listed below. also, because of your history of heart failure, you should weigh yourself every morning, md if weight goes up more than 3 lbs. it was a pleasure taking care of you in the hospital! followup instructions: department: medical group when: monday at 3:45 pm with: dr. building: (, ma) campus: off campus best parking: on street parking procedure: flexible sigmoidoscopy diagnoses: congestive heart failure, unspecified atrial fibrillation acute on chronic diastolic heart failure old myocardial infarction long-term (current) use of anticoagulants anticoagulants causing adverse effects in therapeutic use hemorrhage of gastrointestinal tract, unspecified diverticulosis of colon (without mention of hemorrhage) internal hemorrhoids without mention of complication 

Answer: The patient is high likely exposed to