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: amoxicillin / dilantin / adhesive tape / atenolol / zestril / sulfa (sulfonamides) attending: chief complaint: bleeding from urethra major surgical or invasive procedure: cystoscopy with urethral polypectomy and cauterization of bleeding in urethra history of present illness: this is a year-old female with a history of htn, a-fib on plavix, hypothyroidsim (grave's s/p thyroidectomy), chronic renal disease (baseline 1-1.3), s/p urethral polyp excision 7 days ago who presents with bleeding. she has had an extensive 2 year history of bleeding requirng cautery to the polyp. she underwent removal at 7 days ago and bleeding had stopped post-op for several days. however, the morning of she awoke to her linens satuarted with blood and was brought to the ed. she had restarted her plavix 2 days prior to admission after stopping them for the surgery. . in the ed, 97.5 hr> 58, bp 102/48 rr:16, 99% ra. her initial hct was 25.9. a pelvic u/s was performed and showed likely hematoma in the bladder and 3mm endometrial stripe. she was evaluated by both urogyn and urology. a speculum exam did not show bleeding from the vagina or a fisulous tract. a foley was placed and gauze was placed in the vaginal vault. urology irrigated the foley and removed some clots and her urine briefly cleared. however, she again began to bleed and repeat hct was 20.0. she was hypotensive to the 80/40's and responded to 1l ivf bolus. she was transfused 1u of prbc and transferred to the for further management. she was also given cipro and ua was grossly positive, but patient denied dysuria, fevers, chills. past medical history: 1. hypertension 2. shingles - 3. chronic kidney disease (baseline 1.0-1.3) 4. pancytopenia - negative spep and upep in the past. felt to be most likely due to myelodysplastic syndrome. 5. tia - 6. atrial fibrillation - the patient is not anticoagulated due to a past subdural hematoma. 7. subdural hematoma 8. sinus arrest with junctional tachycardia in the mid requiring pacemaker placement 9. graves' disease status post thyroidectomy and radiation 10. hypothyroidism 11. osteoarthritis 12. falls 13. thoracic aortic aneurysm at the level of the diaphragm - a ct was obtain for comparison on and aneurysm was unchanged. it measured 4 cm. 14. colon polyps status post removal - 15. anemia 16. hemorrhoids 17. urethral polyps 18. history of laryngeal spasm 19. frontal gait syndrome - diagnosed by dr. in . 20. urethral polyp s/p cautery ed social history: the patient is widowed and lives with her daughter in . she is retired from working as a bookkeeper. there are no stairs within the home but there are 14 stairs to leave the house. no alcohol or tobacco. the patient utilizes a walker. family history: her mother had breast cancer, and died of heart disease at age 84. her father died of cad at age 78. her brother died of appendiceal cancer at age 72. physical exam: vitals: t:95.5 bp:120/43 hr:60 rr:13 o2sat:100% gen: elderly female, frail appearing, but nad heent: eomi, perrl, sclera anicteric, mmm, op clear neck: no jvd, no cervical lymphadenopathy, trachea midline cor: rrr, ii/vi sem, normal s1 s2 pulm: bibasilar crackles, otherwise ctab, no w/r abd: soft, nt, nd, +bs ext: no c/c/e neuro: alert, oriented to person, place, and time. cn ii ?????? xii grossly intact. moves all 4 extremities. strength 5/5 in upper and lower extremities. patellar dtr +1. plantar reflex downgoing. skin: no jaundice, cyanosis, or gross dermatitis. no ecchymoses. pertinent results: 06:15am blood wbc-5.9 rbc-3.78* hgb-10.7* hct-31.4* mcv-83 mch-28.4 mchc-34.2 rdw-16.4* plt ct-96* 01:11am blood hct-32.7* 08:30pm blood wbc-5.5 rbc-3.26* hgb-9.2* hct-27.7* mcv-85 mch-28.3 mchc-33.3 rdw-16.0* plt ct-94* 02:40pm blood wbc-4.9 rbc-3.95* hgb-11.2* hct-33.5* mcv-85 mch-28.5 mchc-33.5 rdw-16.4* plt ct-114* 08:28am blood wbc-4.9 rbc-4.01* hgb-11.5* hct-33.6* mcv-84 mch-28.6 mchc-34.2 rdw-16.4* plt ct-107* 03:38am blood wbc-5.3 rbc-3.74* hgb-10.7* hct-31.9* mcv-85 mch-28.5 mchc-33.5 rdw-16.0* plt ct-94* 11:08pm blood wbc-6.2 rbc-3.89* hgb-11.0* hct-33.0* mcv-85 mch-28.2 mchc-33.3 rdw-15.8* plt ct-87* 08:04pm blood wbc-4.6 rbc-3.87* hgb-11.2* hct-33.1*# mcv-86 mch-28.9 mchc-33.8 rdw-15.4 plt ct-87* 11:25am blood hct-20.0*# 03:20am blood wbc-3.6* rbc-3.23*# hgb-9.6*# hct-28.5* mcv-88 mch-29.6 mchc-33.7 rdw-14.7 plt ct-98* 12:40am blood hct-23.9* 08:40pm blood wbc-3.8* rbc-2.31* hgb-6.6* hct-20.0* mcv-86 mch-28.5 mchc-33.0 rdw-15.2 plt ct-130* 01:50pm blood wbc-4.3 rbc-2.93* hgb-8.2* hct-25.9* mcv-88 mch-28.2 mchc-31.9 rdw-14.6 plt ct-155 08:40pm blood neuts-76.2* lymphs-18.0 monos-3.7 eos-1.4 baso-0.7 01:50pm blood neuts-71.4* lymphs-19.9 monos-4.2 eos-3.5 baso-0.9 03:38am blood pt-12.7 ptt-28.8 inr(pt)-1.1 11:08pm blood pt-12.5 ptt-28.2 inr(pt)-1.0 12:04am blood pt-13.2 ptt-26.9 inr(pt)-1.1 08:10pm blood fdp-40-80* 08:04pm blood fibrino-178 06:15am blood glucose-68* urean-21* creat-1.0 na-139 k-4.1 cl-111* hco3-13* angap-19 10:22pm blood glucose-72 urean-23* creat-0.8 na-137 k-4.0 cl-110* hco3-14* angap-17 05:20am blood glucose-73 urean-21* creat-0.7 na-140 k-3.8 cl-114* hco3-17* angap-13 03:38am blood glucose-76 urean-21* creat-0.9 na-136 k-6.3* cl-111* hco3-18* angap-13 11:08pm blood glucose-92 urean-21* creat-0.8 na-138 k-3.7 cl-111* hco3-18* angap-13 03:20am blood glucose-90 urean-23* creat-1.1 na-139 k-5.3* cl-110* hco3-20* angap-14 08:40pm blood glucose-122* urean-28* creat-1.3* na-139 k-4.3 cl-107 hco3-24 angap-12 01:50pm blood glucose-113* urean-29* creat-1.5* na-138 k-4.1 cl-104 hco3-23 angap-15 03:20am blood alt-10 ast-38 alkphos-36* totbili-0.6 06:15am blood calcium-7.4* phos-3.6 mg-1.5* 10:22pm blood calcium-7.4* phos-3.6 mg-1.6 05:20am blood calcium-6.9* phos-3.0 mg-1.8 03:20am blood albumin-2.9* calcium-7.4* phos-4.2 mg-2.1 08:10pm blood d-dimer-* 12:21am blood type-art temp-35.0 po2-78* pco2-25* ph-7.39 caltco2-16* base xs--7 12:21am blood lactate-1.4 10:34pm blood lactate-1.3 03:47am urine color-red appear-cloudy sp -<1.005 03:47am urine blood-lg nitrite-neg protein->300 glucose-100 ketone-40 bilirub-lg urobiln->8 ph-8.5* leuks-lg 03:47am urine rbc->50 wbc-* bacteri-few yeast-none epi-0 08:40pm urine color-red appear-cloudy sp -1.010 08:40pm urine blood-lg nitrite-pos protein-300 glucose-250 ketone- bilirub-lg urobiln-8* ph-9.0* leuks-lg 08:40pm urine rbc->50 wbc-21-50* bacteri-mod yeast-none epi-0 pelvic us : 1. normal 3-mm endometrium. 2. large heterogeneous mainly echogenic mass within the bladder is consistent with a hematoma/clot, although other etiologies are possible. correlate clinically. 3. no adnexal mass. 4. given the history of ureteral polyps, note that this study is not sensitive in assessing this. cxr : impression: no acute findings with no change since the previous study. path : 1. polypoid fragments of markedly cauterized fibroconnective tissue with acute and chronic inflammation and thrombus. 2. no definitive urothelium or squamous epithelium identified; see note. ecg : a-v sequentially paced rhythm. compared to the previous tracing of no significant change. cxr : bilateral pleural effusions with adjacent atelectasis are new. mild to moderate cardiomegaly is stable. aorta is tortuous. there is no pneumothorax. right transvenous pacemaker leads terminate in the standard position in the right atrium and right ventricle. no evidence of chf. urine culture: no growth , blood cultures 7/21 no growth to date at time of discharge. brief hospital course: this is a year-old woman with a hypertension and atrial fibrilation on plavix who presented with hematuria. she was found to have hemodynamically significant bleeding with sbp to 80, hct to 20. she also had a significant clot in her bladder. she had a 3 way irrigating catheter placed and was transfused total of 5 units of packed red cells. her bleeding persisted, though her vital signs and hct stabilized. she was taken to the or with urogyn and had cystoscopy with polypectomy and cautery. her bleeding improved. she had additional small bleeding requiring replacement of 3 way irrigating catheter but this stopped and her hct was stable so she was discharged with the catheter on to follow up in short interval with dr. . during this time her plavix was held, which was given for a.fib. this was discussed with dr. , her cardiologist, who agreed to stopping this in the short term, with discussion of restarting it on follow up. also during this time her amlodipine was held, but her blood pressure improved to 140/60 so this was restarted. she developed an anion gap and non-gap acidosis thought due to ketones from being npo and hyperchloremia for ivf. this improved by discharge. she was noted to have bacteriuria so was treated with ciprofloxacin empirically for 7 day course but her urine cultures were no growth. she was continued on levothyroxine for hypothyroidism. medications on admission: colace miralax estrace cream plavix 75mg daily amlodipine 2.5mg daily levothyroxine 50mcg daily with extra tab on sunday calcium and vitamin d iron 325 daily discharge medications: 1. levothyroxine 50 mcg tablet sig: one (1) tablet po daily (daily): plus additional tab on sunday. 2. acetaminophen 325 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 3. ciprofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 1 days. disp:*1 tablet(s)* refills:*0* 4. amlodipine 2.5 mg tablet sig: one (1) tablet po once a day. 5. miralax 17 gram (100 %) powder in packet sig: one (1) packet po once a day as needed for constipation. 6. colace 100 mg capsule sig: one (1) capsule po twice a day. 7. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po once a day. 8. calcium 500 + d (d3) 500-125 mg-unit tablet sig: one (1) tablet po three times a day. discharge disposition: home with service facility: homecare discharge diagnosis: hemturia secondary to urethral polyp atrial fibrilation, s/p pacemaker hypertension acute blood loss anemia thrombocytopenia urinary tract infection discharge condition: stable vital signs with bp 140/64, hr 60, comfortable, with foley in place draining clear urine. discharge instructions: you were admitted to the hospital with bleeding from your urethra. you required blood transfusions. you went to the or to stabilize the bleeding. your blood count stabilized and your bleeding stopped. you are being discharged to follow up with dr. next week. due to bleeding your plavix was stopped. you are being treated for a urinary tract infection, for which you need one additional day of ciprofloxacin. if you develop additional bleeding, dizziness or lightheadedness, fevers or chills, pain at the catheter, please call dr. or return to the er at for evaluation. followup instructions: please follow up with dr. next wednesday, . please call for this appointment. provider: clinic phone: date/time: 10:00 provider: . phone: date/time: 10:40 provider: , md phone: date/time: 10:00 procedure: endoscopic excision or destruction of lesion or tissue of urethra diagnoses: acidosis urinary tract infection, site not specified acute posthemorrhagic anemia thoracic aneurysm without mention of rupture hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation myelodysplastic syndrome, unspecified chronic kidney disease, stage iii (moderate) hemorrhage complicating a procedure other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure cardiac pacemaker in situ personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits delirium due to conditions classified elsewhere postsurgical hypothyroidism other agents affecting blood constituents causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to