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: codeine / percocet attending: chief complaint: melena/maroon stools major surgical or invasive procedure: upper endoscopy - no noted active bleeding colonoscopy - no noted active bleeding push enteroscopy - no noted active bleeding. alot of clot seen in jejunum - therefore assumed to be site of previous bleeding history of present illness: 75f with pmh of cad s/p cabg and mult pcis, dmii, pvd, cva presenting with 3 days "chocolate/maroon" stools. pt having dark stools/day. pt reports feeling "close to passing out" this pm on the phone with her dtr, ? intermittent loc. states she had < 10minutes chest tightness today with activity with some assoc dyspnea; resolved with rest. on arrival to ed, bp 110s and hr 60s. guaiac positive with frank melena. . hct 21.3, down from 34 ten days ago, inr 4.9 (on coumadin post cva). ng placed, lavage clear for 600ml, non-bilious. gi consulted. given 1u prbc. ecg with nonspecific t-wave changes - initial trop <0.01. ua and cxr normal. head ct neg for bleed past medical history: pmh: * cardiac a) coronary artery disease s/p cabg lima-lad, svg-rca, svg-cx s/p multiple stents and raditation b) rhythm: history of a-fib with cardioversion c) pump: ef 50% from * hypertension * diabetes type ii, on insulin * hyperlipidemia * status post mca distribution stroke in with resolution of symptoms but slight residual * peripheral disease with left subclavian, iliac, left carotid stent, left vertebral artery stent * mca infarct initiall with r sided weakness and aphasia, symptoms now resolved social history: no tob, no etoh, lives at home alone and carries out most activities of daily life alone including shopping, driving short distances. retired nurse. family history: non-contributory physical exam: physical exam on admission: pe: vs: t 123/40 60s 16 100% 2l nc; not orthostatic (sbp lying flat 120, hr 65, sitting upright 113, hr 70) gen: nad, o x 3 heent: pale conjunctivae, eomi, anicteric, dry mm cv: rrr, hsm at apex chest: cta b/l abd: soft, obese, nt, + bs, healed midline incision extr: trace pedal edema neuro: moving all 4 extr, cn ii-xii intact pertinent results: 10:41am blood wbc-6.9 rbc-3.18* hgb-9.3* hct-26.8* mcv-84 mch-29.3 mchc-34.8 rdw-14.9 plt ct-140* 05:05am blood wbc-7.8 rbc-3.20* hgb-9.3* hct-27.4* mcv-86 mch-29.0 mchc-33.8 rdw-15.4 plt ct-165 12:14am blood wbc-8.6 rbc-3.62* hgb-10.6* hct-30.5* mcv-84 mch-29.2 mchc-34.7 rdw-14.9 plt ct-154 05:56pm blood wbc-10.2 rbc-3.46* hgb-10.1* hct-29.5* mcv-85 mch-29.1 mchc-34.1 rdw-15.6* plt ct-137* 11:23am blood wbc-9.8 rbc-3.63* hgb-10.6* hct-30.0* mcv-83 mch-29.2 mchc-35.3* rdw-15.2 plt ct-151 02:12am blood wbc-9.8 rbc-3.58* hgb-10.6* hct-29.4* mcv-82 mch-29.7 mchc-36.1* rdw-15.9* plt ct-125* 08:35pm blood wbc-9.9 rbc-3.83* hgb-11.3* hct-31.4* mcv-82 mch-29.6 mchc-36.1* rdw-15.4 plt ct-131* 01:41pm blood wbc-10.5 rbc-3.37* hgb-9.8* hct-27.9* mcv-83 mch-29.0 mchc-35.0 rdw-16.2* plt ct-123* 03:34am blood wbc-11.8* rbc-3.28* hgb-9.5* hct-26.8* mcv-82 mch-28.9 mchc-35.4* rdw-16.0* plt ct-140* 11:27pm blood hct-29.2* 03:54pm blood wbc-9.3 rbc-2.92* hgb-8.3* hct-24.0* mcv-82 mch-28.3 mchc-34.5 rdw-15.9* plt ct-124* 11:28am blood wbc-7.6 rbc-2.41* hgb-7.1* hct-20.5* mcv-85 mch-29.3 mchc-34.5 rdw-15.2 plt ct-131* 08:44am blood hct-17.7* 04:21am blood hct-17.5* 03:17am blood wbc-8.2 rbc-2.03* hgb-5.7* hct-17.7* mcv-87 mch-27.8 mchc-31.9 rdw-14.6 plt ct-159 01:49am blood wbc-9.1 rbc-2.44* hgb-7.1* hct-21.1* mcv-87 mch-29.1 mchc-33.6 rdw-14.5 plt ct-209 11:55pm blood wbc-9.8 rbc-2.65* hgb-7.7* hct-23.0* mcv-87 mch-28.9 mchc-33.3 rdw-14.8 plt ct-211 04:50pm blood wbc-10.3 rbc-2.47*# hgb-7.0*# hct-21.3*# mcv-86 mch-28.2 mchc-32.7 rdw-15.4 plt ct-223 10:41am blood plt ct-140* 05:05am blood plt ct-165 05:05am blood pt-13.2 ptt-23.5 inr(pt)-1.2 03:34am blood pt-14.8* ptt-29.5 inr(pt)-1.5 11:27pm blood pt-14.5* ptt-27.2 inr(pt)-1.4 08:44am blood pt-15.3* inr(pt)-1.6 03:17am blood pt-16.6* ptt-28.2 inr(pt)-1.8 01:49am blood pt-23.9* ptt-29.2 inr(pt)-3.8 04:50pm blood pt-27.2* ptt-29.3 inr(pt)-4.9 05:05am blood glucose-135* urean-38* creat-0.9 na-141 k-5.8* cl-105 hco3-31 angap-11 04:50pm blood glucose-250* urean-43* creat-0.9 na-139 k-4.4 cl-105 hco3-24 angap-14 01:49am blood alt-18 ast-27 ld(ldh)-211 ck(cpk)-43 alkphos-43 amylase-33 totbili-0.2 04:50pm blood ck(cpk)-43 01:49am blood ck-mb-1 ctropnt-<0.01 11:55pm blood ck-mb-notdone ctropnt-<0.01 04:50pm blood ck-mb-notdone ctropnt-<0.01 01:49am blood caltibc-276 hapto-82 ferritn-17 trf-212 brief hospital course: a/p: 75 y/o f h/o signif cad, s/p 3 vessel cabg, mult ptca with stents, dm, pvd, cva, presented with 3 days of melena, lh. 1) gi bleed ?????? guaiac (+) melena in ed, with hct drop from 34 -> 17. continued melenatic stools on admission to icu. hct maintained > 28 with blood transfusions. egd, c-scope, and push enteroscopy by gi negative for active bleeds. however, push enteroscopy did show fresh clot in jejunum indicating jejunum as likely source of bleed. ct abd domonstrated no retroperitoneal bleed. pt stablized without active signs of bleeding, without significant hct drop and transferred to floor on . patient was stable with stable hct and 2 bowel movements without blood and guiac (-). abdominal angiogram did not reveal the source of the bleed. while gi recommended restarting anticoagulation, the primary team decided to only restart the patient on aspirin since the original purpose of the anticoagulation was for stroke prophylaxis after pt was discovered to be in atrial fibrillation, which appears to ahve resolved at the patient is now in normal sinus rythem. . 2) coagulopathy ?????? patient was on coumadin for h/o cva, inr 4.9 at presentation. reversed with ffp and vit k, with stabilization of inr to 1.2 - plans to restart anti-coag after no longer increased risk of further gi bleed. . 3) history of cad. patient was maintained on her statin but her hypertensive medications and anticoagulation were held because of pateint's active bleeding and the risk of hypotension. patient was transfused to keep her hematocrit greater than 28 because of the pateint's history of cad. pt experienced episodes of brady-tachycardia without symptoms during push enteroscopy and later on the floor, she was noted to brady down to the mid to high 30's, again without any symptoms. dr. (pt's cardiologist) was notified. . 4) dm - pt was maintained on glargine and ssi w/ finger stick monitoring. . 5) hypoth - patient was maintained on her usual outpatient dose of synthroid. . 6) prophylaxis - pt maintained on iv pantoprazole during stay for gi bleed. patient was also on pneumoboots for dvt prophylaxis since all anti-coagulation was held secondary to her gi bleed. . 7) fen - tolerating food and liquids without difficulty. . 8) code - full medications on admission: synthroid 112mcg asa 325 lasix 40 zocor 60 diovan 40 lisinopril 2.5 omeprazole fe discharge medications: 1. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 2. simvastatin 40 mg tablet sig: 1.5 tablets po daily (daily). disp:*45 tablet(s)* refills:*2* 3. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 4. multivitamin capsule sig: one (1) cap po daily (daily). disp:*30 cap(s)* refills:*2* 5. levothyroxine sodium 112 mcg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. captopril 12.5 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 7. lasix 40 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: 1.) acute gi bleed discharge condition: good - hemodynamically stable, hematocrit stable, tolerating po's, and ambulating freely discharge instructions: take medications as directed below. please follow up with your primary care doctor in weeks for a check up and a lab test to make sure that your blood hematocrit level has remained stable. additionally, please discuss the problem with your eye. please inform your doctor immediately if you experience any more blood in your stool or vomit, weakness, dizziness, nausea, vomiting, fatigue, abdominal pain, dark, maroon colored stools, or any other concerning symptom. return to the hospital immediately if you pass a large amount of blood in your stool all at once. weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet followup instructions: 1. provider: , m.d. where: cardiac services phone: date/time: 9:00 2. provider: , m.d. where: cardiac services phone: date/time: 11:00 3. provider: study where: cc clinical center radiology phone: date/time: 1:00 4. provider: , m.d. where: cardiac services phone: date/time: 1:45 md procedure: other endoscopy of small intestine other endoscopy of small intestine colonoscopy transfusion of packed cells transfusion of other serum diagnoses: unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism atrial fibrillation aortocoronary bypass status mitral valve insufficiency and aortic valve insufficiency other and unspecified hyperlipidemia long-term (current) use of anticoagulants angiodysplasia of intestine with hemorrhage sinoatrial node dysfunction diseases of tricuspid valve 

Answer: The patient is high likely exposed to