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: rectal bleeding major surgical or invasive procedure: flex sig with electrocautery and epinephrine injection history of present illness: patient is a yo male with h/o prostate ca, copd, afib/aflutter and sss, with recent sigmoidscopy on , where localized whitish sclerotic mucosa in perianal, internal area (possibly ulcerated near nodule) were noted in the anus. cold forceps biopsies were performed for histology. a single 10mm polyp was found in the appears to be part of an internal hemorrhoid but has different mucosal appearance. patient reports that after dinner today he defecated and had quarts of brbpr. patient had no cp, sob, + lower quadrant abd pain times months that is stable. patient reports no nausea or vomiting, no recent fevers, nsaid use or sick contacts. then brought to ed by son, and there contiued to have brbpr. initial hct 39.3 at 8:30pm and then dropped to 29 at 1am. patient remaied hemodynamically stable with sbp 140-150 and hr in 60s. patient given 4 u ffp and 10mg vit k sq. ng lavage negative. ekg with no acute ischemic changes. plans made for ct of abd and admission to micu for colonoscopy and possible bleeding scan. past medical history: 1. prostate ca s/p xrt 2. bladder ca, papillary urothelial carcinoma, high grade (dx in ), nonmetastatic (recent negative cystoscopy ) 3. lumbar fracture -- followed closely in pain clinic w/ multiple steroid injections, on chronic opioid therapy 4. copd (pfts : fvc 59% predicted, fev1 58% predicted and fev1/fvc 98% predicted) 5. pud with gib in 6. atrial fibrillation and ?sick sinus syndrome 7. hx of rheumatic fever 8. hx of cva 9. s/p appendectomy 10. s/p lap chole in 11. chronic le edema- recently saw dr. for evaluation 12. tachy-brady sundrome 13. afib-aflutter on coumadin social history: denies alcohol use since (used to drink vermouth); 75 pack year smoking history (smoked 2-3 packs per day), quit in ; lives in house- has 24 hr caretaker who is with him tonight. full code- discussed with patient on admission; born and raised in family history: nc physical exam: pe: 95.9 137/61 65 12 100% 3l gen:nad, a and o times 3 heent:ncat< eomi, op clear, dry mm, no jvd cv: rrr, no m, distant hs pulm:mod air movement, crackles at bases abd:+bs, soft, mild distension in lower quadrants bilat, no rebound, no gaurding. no testicular pain with elevation of ttestis. ext:no c/c- + pedal edema neuro:cn ii-xii intact, strength 5/5, maew pertinent results: 08:23pm hgb-12.8* calchct-38 08:24pm pt-28.0* ptt-35.5* inr(pt)-2.9* 08:24pm ck-mb-4 ctropnt-<0.01 08:24pm lipase-35 10:26pm hgb-11.0* calchct-33 cxr: chronic consolidation and atelectasis in the right middle lobe have improved. upper lungs clear. no pleural effusion or evidence of central adenopathy. heart size normal. abd ct: 1. active contrast extravasation in the inferior rectum. given the location, hemorrhoidal bleeding is the most likely cause. alternatively, this could represent bleeding from a rectal artery. 2. stable small bilateral pulmonary nodules. 3. multiple bilateral renal cysts. 4. l5 wedge compression deformity. flex sig: bleeding site was identified approximately 3 cm from ano-rectal junction. there was a possible dieulafoy's lesion that was actively bleeding. the overlying clot was removed. blood in the rectum, sigmoid colon and descending colon bleeding possibly secondary to dieulafoy's lesion. hemostasis was successful. brief hospital course: mr. is a yo man with pmh sig for afib on coumadin copd, hx of cva and pud who presented to the ed with brbpr, was transferred to the micu and seen by gi s/p flex sig with bleeding ulcer which was electrocauterized and s/p epinephrine injection. his bleeding resolved, and his hct stablized. he was able to tolerate po and had no further brbpr, melena or abdominal pain at discharge. his coumadin was not restarted. it was left to his pcp to reevaluate risk and benefits of coumadin vs bleed. his lowest hct was 21 for which he received 2 units of prbcs. he was discharged on hospital day number 4 with hct of 31 and asymtomatic with ambulation. he was continued on all outpt meds, cautioned about nsaid use and no coumadin. discharge medications: 1. carbidopa-levodopa 25-100 mg tablet sig: tablet po tid (3 times a day). 2. protonix 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po every twelve (12) hours. disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 3. atrovent 18 mcg/actuation aerosol sig: one (1) inhalation every six (6) hours. disp:*1 inhaler* refills:*2* 4. albuterol 90 mcg/actuation aerosol sig: inhalation every 4-6 hours as needed for shortness of breath or wheezing. disp:*1 inhaler* refills:*2* 5. verapamil 120 mg tablet sustained release sig: one (1) tablet sustained release po q24h (every 24 hours). discharge disposition: home with service facility: homecare discharge diagnosis: lower gastrointestinal bleed from rectal ulcer atrial fibrillation copd discharge condition: stable to be discharged to home with home physical therapy. discharge instructions: please continue all medications as prescribed. your coumadin should be held for more days. please do not restart your aspirin until you follow up with your primary care physician. if you have fevers, chills, sweats, chest pain, shortness of breath, nausea, vomiting, diarrhea, blood in your stool or black stool, please come back to the emergency department or call dr. office. followup instructions: 1. please call dr. office at to schedule a follow up appointment in 1 week. unfortunately we were unable to make an appointment due to the president's day holiday. --you should have your hematocrit checked at this appointment. --you should also discuss restarting your coumadin at this appointment. 2. provider: , m.d. phone: date/time: 11:30 3. provider: breathing test phone: date/time: 11:10 md procedure: endoscopic destruction of other lesion or tissue of large intestine transfusion of packed cells transfusion of other serum diagnoses: chronic airway obstruction, not elsewhere classified atrial fibrillation personal history of malignant neoplasm of prostate chronic kidney disease, unspecified paralysis agitans long-term (current) use of anticoagulants personal history of malignant neoplasm of bladder dieulafoy lesion (hemorrhagic) of intestine 

Answer: The patient is high likely exposed to