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: melena major surgical or invasive procedure: egd history of present illness: mr is a 73 y.o. m with history of squamous ca of the soft palate (t2n0)- s/p xrt/chemo in - now presenting with 3 days of black stools. pt was feeling well until thursday when he noticed very mild nausea and 2 episodes of black stool. he had 2-3 episodes of black stool on friday, and then awoke on saturday am feeling so weak that he could barely stand. +lh/sob. additional black bm --> called 911-> -. . at osh ed, he was noted to have hct of 10 and coffee grounds that didn't fully clear on ng lavage. bp at dropped to the 80s, with tachycardia to the 120s- he received several liters of fluid and two units of o-negative blood. received dose of nexium- sent to . . takes asa/plavix but denies other nsaids. notes ?prior ulcer bleed many years ago. . in the ed he was seen by gi, who lavaged bright red blood but unable to clear it. he was transfused 2u prbcs for a hct of 23. sbp were stable at 130-140s. past medical history: 1. soft palate squamous ca diagnosed in , t2no- s/p xrt//taxol completed in . prior g-tube. no evidence of recurrence on recent laryngoscopy by ent in . proximal esophageal dilation procedure for ues stricture on . - complicated by hospitalization for pna and chf - followed by dr. (ent) and rad-onc 2. prior egd during peg placement- noted gastritis and ?duodenal varices 3. carotid stenosis- s/p carotid stenting to r-side in 4. htn 5. mca aneurysm s/p l craniotomy social history: retired florist. he lives alone in . family involved. 50pkyrs, quit 8weeks ago. reports heavy etoh in the past, quit 15years ago. family history: father with aml physical exam: micu admission pe: physical exam: 98.8 92 137/58 99% 2lnc nad- alert and conversent very dry mucous membranes, edentulous rrr, distant s1s2 lungs clear abdomen soft- no hepatosplenomegaly on my exam, well healed peg tube site per gi: rectal with trace amount of melena in otherwise empty vault no peripheral edema, 1+ pulses, warm brief hospital course: . # ugib: pt was found with a hct of 10 at hospital and coffee grounds that didn't fully clear on ng lavage. his bp at dropped to the 80s, with tachycardia to the 120s. he received several liters of fluid and two units of prbcs. he was subsequently transferred to where he was evaluted by gi and lavaged bright red blood taht could not be cleared. he was transfused 2 additional units of prbcs for a hct of 23. sbp were stable at 130-140s. he had an egd on the night of admission which did not show a clear source of bleed. in addition there was an initial question of duodenal varices. he was then transferred to the icu for closer monitoring and started on a ppi gtt. had abdominal ultrasound with dopplers which was unremarkable and without evidence of portal hypertension making duodenal ulcers unlikely. he then had a repeat egd which showed folding in the duodenum likely accounting for intial concern of varices. it did show duodenal ulcer. pt subsequently had a stable hct and was transferred to the floor. his ppi was changed to an oral ppi. he underwent a colonoscopy which showed diverticui in the sigmoid and descending colon as well as internal hemorroids. given that there was still a concern that the source of bleed was not found, he had a capsule endoscopy (placed via egd). the capsule study was not capturing but during the procedure but he was found to have a small bleeding avm that was clipped and cauterized. thus it was felt his bleed could have been due to this avm and further pursuit of a capsule study during this hospitalization was felt unneccessary. his diet was subsequently advanced. his hct remained stable. he was discharged with instructions that gi would be in touch in case they were indeed able to capture the study as hoped and if he needed additional follow up as an outpatient. . # cardiac/htn: pts metoprolol and ace were intially held but restarted once his hct and bp were stable. . # carotid stent/atherosclerosis: both the pts asa/plavix were initially held in setting of bleed. surgery was following and wanted pt to be restarted as soon as possible however given bleed they were not restarted. his asa was restarted at 81mg daily on hospital day #2 but plavix not restarted before discharge as it was felt to be too high of a risk. the patient will follow up with his pcp and will likely need to restart his medication in days as long has his hct is stable and he does not have further signs of bleeding. his pcp was via letter to let him know that the plavix had been held and would need to be restarted. . #fever-pt had a fever to 101.9 2 days prior to discharge. he was asymtomatic and did not have an elevation in his wbc. a u/a was negative, blood cultures were sent (ngtd on day of discharge) and a cxr showed no evidence of infiltrate. no further intervention felt necessary. medications on admission: medications: asa 81mg plavix 75 lisinopril 20mg daily metoprolol xl 25mg daily prevacid (ran out 3 days ago, was being transitioned to nexium) zocor 20mg qd discharge medications: 1. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 2. lisinopril 20 mg tablet sig: one (1) tablet po once a day. 3. pantoprazole 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* 4. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 5. metoprolol succinate 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). discharge disposition: home discharge diagnosis: diverticulosis duodenal ulcer avm . secondary htn squamous cell ca of soft palate s/p xrt/chemo discharge condition: stable discharge instructions: you were admitted to the hospital because you were found to have a low blood count and had some bleeding from your colon. you received 2 units of blood while you were here. you had some procedures done to identify the site of bleeding. you have an ulcer in your stomach and were started on a medication called pantoprazole to help reduce stomach acid. in addition you were found to have some diverticuli in your colon as explained while you were here which likely contributed to the bleed. . your plavix was held because it causes thinning of your blood and makes the bleeding worse. you will need to continue to hold this medicine until you follow up with your primary care doctor. you can continue your aspirin. . if you have any ongoing lightheadedness, dizziness, bleeding from below, chest pain or shortness of breath, please call your doctor or return to the er. . please follow up as below. please call and make an appointment with. dr . he was notified that you were hospitalized and he will try to get you in to see him in the next few weeks. if you don't hear from him by monday please call his office to make an appointment. followup instructions: please follow up with your pcp dr . provider: , m.d. phone: date/time: 8:45 provider: , date/time: 9:20 provider: lab phone: date/time: 11:00 md procedure: other endoscopy of small intestine endoscopic control of gastric or duodenal bleeding endoscopic destruction of other lesion or tissue of large intestine transfusion of packed cells diagnoses: congestive heart failure, unspecified unspecified essential hypertension acute posthemorrhagic anemia occlusion and stenosis of carotid artery without mention of cerebral infarction diverticulosis of colon (without mention of hemorrhage) internal hemorrhoids without mention of complication angiodysplasia of stomach and duodenum with hemorrhage leukocytopenia, unspecified personal history of malignant neoplasm of other and unspecified oral cavity and pharynx angiodysplasia of intestine (without mention of hemorrhage) duodenal ulcer, unspecified as acute or chronic, without hemorrhage or perforation, without mention of obstruction 

Answer: The patient is high likely exposed to