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 / codeine / heparin agents attending: chief complaint: melena major surgical or invasive procedure: gi bleeding scan history of present illness: 75 yo f with extensive history of gi bleeds due to avm presents with melena x 1 week and dizziness x 1. (hct dropped from 27->16) she was admitted twice in , and once in and for episodes of hematochezia and melena. she has sigmoid diverticulosis, pvd, barretts esophagitis and diffuse avm (stomach -> rectum). her last colonoscopy and egd were and respectively. has afib but not on coumadin. also has stable chronic thrombocytopenia. does not have any pain at this time. no brbpr, cp, sob, v, ha, dysuria, hematemesis. she does report nausea, and decreased po intake. in the ed she had an ng tube that was placed and was found to be negative on lavage. started on iv protonix and received 1u prbc and transferred to the icu for closer monitoring. past medical history: lower gi bleeds: scopes (most recently ) w/avms, diverticulosis throbocytopenia (hit) mrsa endocardiitis () cri, baseline creat cad s/p mi & cabg ' chf ef >=55% (diastolic) dm2 on insulin htn, hyperlipid paroxysmal atrial fibrillation pud, barrett's esoph asthma hypothyroidism osteoarthritis s/p chole social history: no etoh, tobacco, and drugs. lives with daughter family history: significant for cad and dm physical exam: t 97.5 p 84 bp 153/67 r 17 o2 97% on ra gen - nad, obese, a+o x 3 heent - small pupils 2mm minnimally reactive, round, equal cor - rrr no m/r/g chest - cta b abd - s/nt/nd + bs rectal guiac + by ed ext - w/wp, no c/c/e pertinent results: echo () - trace ar, mr, 2 tr, aortic valve veg colonoscopy () angioectasias in the rectum, ceum, and transverse colon egd () - short sigmoid barretts, 2 nonbleeding angioectasias, cauterized jejunal angioectasias colonoscopy ()- cecal polyp->polypectomy, cecal angiotectasia (thermal tx), grade 1 internal hemorrhoids egd - () - hiatal hernia, no bleed colonoscopy () sigmoid diverticula, no bleeding egd -() angio ectasia of distal jejunum, s/p thermal tx 03:13pm glucose-193* urea n-75* creat-3.7* sodium-142 potassium-4.1 chloride-107 total co2-25 anion gap-14 basline cr - () 03:13pm calcium-8.1* phosphate-3.6 magnesium-2.1 03:13pm wbc-5.0 rbc-1.75* hgb-5.5* hct-16.5* mcv-95 mch-31.4 mchc-33.3 rdw-17.2* 03:13pm neuts-71.2* lymphs-17.7* monos-4.8 eos-6.2* basos-0.1 03:33pm hgb-5.8* calchct-17 baseline hct high 20's low 30's ekg - regular 85bpm, rbbb, flipped t, inferiorly and anteriolaterally, no changes from prior 03:13pm plt count-121* 03:13pm neuts-71.2* lymphs-17.7* monos-4.8 eos-6.2* basos-0.1 brief hospital course: 75 yo female with multiple gi bleeds secondary to avm presents with another episode of melena and an hematocrit of 16. 1. gi bleed - patient presented with melena most likely secondary to an upper gi source of avm. she was transfused with a total of 4u prbc during her hospital course, and her hct was stable between 27.7 and 29.3. during her hospital course, she did have multiple bowel movements with minimal black stool and mainly brown stool. the gi team was consulted who felt that given she has had multiple scopes in the last couple of months, she most likely would not benefit from another egd with push enterscopy or a pill study. also, the patient was reluctant to have another egd. she did have a gi bleeding scan study that showed no active bleeding at that time. given that she improved clinically and was tolerating po well with a stable hct, and no bright red blood per rectum, it was decided that it would be reasonable to send her home with close follow up. vna was setup for her hct to be drawn on friday morning and faxed over to dr. office. 2. coronary artery disease - she was continued on her outpatient regimen of b-blocker, lipitor and lasix. her aspirin was held in the setting of her gi bleed. 3. hypothyroidism - continued home dose of levothyroxine 4. renal - she has known chronic renal insufficiency, and during her stay, her creatinine remained stable at her baseline. her creat was between 3.5-3.8. 5. diabetes - she was continued on her home regimen of insulin 70/30 at 30 unit sq q am, and 10 u sq q pm. 6. heme - she has known hit and so she was not given any heparin products 7. code - dnr / dni medications on admission: 60mg vit c 500mg qday insulin 70/30 30 units qam/ 10 unit qpm levothyroxine 175 mcg gabapentin 200 lipitor 10 mg qday toporol xl 25mg qday protonix 40mg qday lasix 40mg qday folate 1mg qday vit b complex discharge medications: 1. fexofenadine hcl 60 mg capsule sig: one (1) capsule po bid (2 times a day). 2. levothyroxine sodium 175 mcg tablet sig: one (1) tablet po daily (daily). 3. atorvastatin calcium 10 mg tablet sig: one (1) tablet po hs (at bedtime). 4. fluticasone propionate 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 5. ipratropium bromide 18 mcg/actuation aerosol sig: two (2) puff inhalation qid (4 times a day). 6. toprol xl 25 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po once a day. 7. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 8. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 9. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 10. insulin 70/30 70-30 unit/ml suspension sig: thirty (30) units subcutaneous q am. 11. insulin 70/30 70-30 unit/ml suspension sig: ten (10) units subcutaneous q hs. discharge disposition: home with service facility: vna discharge diagnosis: primary: 1. gi bleed secondary: 1. coronary artery disease 2. hypertension 3. diabetes 4. gerd 5. chronic renal insufficiency 6. hypothyroidism discharge condition: stable discharge instructions: please take all your medications as directed. please call your primary care physician if you experience any broght red blood per rectum, shortness of breath, lightheadedness or dizziness. please follow up with dr. in days. vna nurses will come and draw your blood on friday morning and fax results to dr. . followup instructions: provider: , .d., ph.d.: medical specialties phone: date/time: 4:00 procedure: transfusion of packed cells diagnoses: coronary atherosclerosis of native coronary artery congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism atrial fibrillation asthma, unspecified type, unspecified blood in stool unspecified disorder of kidney and ureter angiodysplasia of intestine (without mention of hemorrhage) 

Answer: The patient is high likely exposed to