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: heparin agents attending: chief complaint: nausea, vomiting major surgical or invasive procedure: intubation history of present illness: 44 yo seen by her pcp on the for viral gastroenteritis with n,v, diarrhea and food intolerance, who presented on the with peristent nausea, resolved abd.pain and was found to be in dka with glucose of 1200, ag of 21 and a bicarbonate of less than 3. a ct scan of the abdomen was done and was positive for portal venous gas within the liver and pneumatosis within loops of ileum in the right hemipelvis. findings were worrisome for ischemic bowel. pt was admitted to the surgery team and was started on piperacillin-tazobactam na 4.5 gm iv and vancomycin hcl 1000 mg iv q 12h. a repeat ct scan one day later was not able to confirm the finding but showed interval development of extensive thickening of the bowel wall of the ileum. she was thought to have ischemic bowel from profound hypovolemia due to dka. pt was started on insulin gtt for management of her dka. later on admission day pt was noted to be in respiratory distress and was intubated. a ct of the head was done and was negative. the anion gap improved and the pt became more clear and stable. she was extubated on the . anion gap now resolved. the pt was also noted to have a drop in her hematocrit of 10 points on the . she was found to be guaiac positive but never had any gross gi bleed. the hematorcit was attributed to slow grade gi bleed as well as hemodilution. no hemolysis labs were send. the pt was transfused 2 u prbc over the subsequent day and increased with her hct appropriately. on the the pt was also noted to have decreased platelet counts, coming down from 395 on admission to 132. hit abx were sent and came back positive on the . all heparin products were stopped and argatroban was started. it was recommended by hematology to start the pt on coumadin with a five day overlap to argatroban for 5 days. . pt currently states she is feeling fine. she denies ha, n, v, abd. pain, cp, sob, joint pain. she had two episodes of watery diarrhea today, with blood (but currently with menstruation). she denies any melena. past medical history: ? diabetes -diet controlled per patient for one year since diagonsis asthma. 2 abortions uterine fibroids social history: sh: divorced, originally from , lives alone, has family in , denies alcohol, tobacco or drug abuse currently or in the past . family history: fh: diabetes type ii in several family members, no heart disease, no malignancy physical exam: 98.4 100/70 106 16 100ra gen: lying in bed, in nad heent: eomi, perrl, moist mucous membranes neck: jvd 8 cm, no lad, no thyroideomegaly chest: cta b/l, mild crackles at bases, negative egophony cv: rrr, s1/s2 intact, sm over rusb radiating into the axillae abd: obese, soft, nt, nd +bs ext: no c/c, 2+ dp, 2+ pitting edema of the b/l le and 1+ of ue, negative sign neuro: cn 2-12 intact. aao x3. strength 5/5 grossly throughout, reflexes 2+ b/l. pertinent results: 01:45pm pt-15.4* ptt-33.1 inr(pt)-1.6 01:45pm plt smr-normal plt count-395 01:45pm hypochrom-1+ anisocyt-1+ poikilocy-normal macrocyt-2+ microcyt-normal polychrom-occasional 01:45pm neuts-88.5* bands-0 lymphs-6.5* monos-4.6 eos-0.2 basos-0.2 01:45pm wbc-21.2* rbc-4.24 hgb-13.4 hct-43.7 mcv-103* mch-31.6 mchc-30.6* rdw-16.9* 01:45pm wbc-21.2* rbc-4.24 hgb-13.4 hct-43.7 mcv-103* mch-31.6 mchc-30.6* rdw-16.9* 01:45pm ck-mb-4 ctropnt-<0.01 01:45pm ck-mb-4 ctropnt-<0.01 04:48pm lactate-2.2* brief hospital course: as above before admission to medicine. 44 yo with possible type one diabetes, presenting in dka with pneumatosis coli/ileal thickening in the setting of severe dehydration, anemia, and hit-ii with positive abx on argatroban. . # hit: antibody positive, makes hit ii more likely although platelets never lower than 90 000. serotonin release assay pending on discharge. pt with increased risk of thrombosis due to hypercoagulable status. all heparin products were stopped. argatroban was started with a goal of ptt 60-80. coumadin was started at 2mg qhs once ptt therapeutic for 24 hourse. platelets started to rise again to normal limits. no evidence of thrombosis was found. as pt was low probability for thrombosis she was switched to fondaparinux and was sent home on fondaparinux, transitioning to coumadin. follow up was arranged with dr. for . clinic was informed about the pt. . # anemia: unclear etiology. initial drop attributed to hemodilution in the setting of preexisting anemia and low grade gi bleed as guaiac postive. no surgical intervention done. hemolysis labs negative. 2u prbc transfused. also low vit b12 - possible related to bowel disease as resorption in the ileum vs pernicious anemia. anti-intrinsic factor antibodies should be check as an outpatient, also ttg to rule out celiac sprue should be considered. on vitamin b12 2000mcg qd for life. gi follow up should be considered. . # diabetes: presented in dka and body habitus more suspicious for type i. gap resolved. gad/ islet cell abx were pending on discharge. sliding scale was adjusted according to recommendations with glargine and issc. it is unusual in that the patient had some mildly elevated sugars over the past year or two and did not present with frank dka until now. . # ileal thickening: most likely ischemic bowel in the setting of dka and profound hypovolemia. predominance in the ileum would be suspicious for crohns disease or yersinia. stool cultures negative for cdiff and yersinia. initially with leukocytosis and improvement with fluids and antibiotics therefore more likely hypovolemia and/or infectious cause. leukocytosis also seen in dka and severe stress reaction. chronic low grade crohns disease affecting the ileum could be considered also given vit b12 deficiency. pain and diarrhea now resolved. antibiotics (flagyl, levofloxacin and fluconazole) were discontinued on day of transfer to medicine team. gi follow up should be considered. . # peripheral edema: resolving medications on admission: none . on transfer: acetaminophen albuterol argatroban fluconazole insulin ipratropium bromide mdi levofloxacin metronidazole pantoprazole discharge medications: 1. acetaminophen 325 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed: do not exceed 4g per day. disp:*20 tablet(s)* refills:*0* 2. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. disp:*qs * refills:*0* 3. ipratropium bromide 18 mcg/actuation aerosol sig: two (2) puff inhalation qid (4 times a day). disp:*qs * refills:*2* 4. cyanocobalamin 500 mcg tablet sig: four (4) tablet po daily (daily). disp:*120 tablet(s)* refills:*2* 5. insulin regular human 100 unit/ml solution sig: one (1) injection as directed: please follow sliding scale. disp:*2 * refills:*2* 6. one touch ultra teststrips sig: one (1) four times a day. disp:*200 * refills:*5* 7. warfarin 2 mg tablet sig: one (1) tablet po hs (at bedtime). disp:*20 tablet(s)* refills:*0* 8. fondaparinux 7.5 mg/0.6 ml syringe sig: one (1) subcutaneous daily (daily): until inr is therapeutic. disp:*7 * refills:*0* discharge disposition: home with service facility: homecare discharge diagnosis: primary - dka ischemic ileitis hit ii anemia diabetes mellitus discharge condition: good, anemia stable, abdominal pain resolved, diabetes controlled with issc and inr 1.2 on coumadin and fondaparinux discharge instructions: please come back to the hospital or see your primary care doctor if you experience any abdominal pain, fevers, shortness of breath, lower extremity swelling, pain or any other concern. . please continue with all medications as prescribed. followup instructions: you will an appointment with today at 4pm with ms for diabetes teaching. they will arrange follow up with for you. . you will have vna services to monitor your coagulation on coumadin. results will be faxed to your primary care doctor dr. . she will adjust the coumadin dose for you. she should also get the following test on you: test for consideration post-discharge: anti-tissue transglutaminase antibody, iga. you have an appointment with dr. on the , at 2.35 pm. . you also have the following appointments scheduled for you: provider: , : date/time: 9:30 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube transfusion of packed cells diagnoses: acidosis anemia, unspecified hypopotassemia anticoagulants causing adverse effects in therapeutic use hemorrhage of gastrointestinal tract, unspecified hypovolemia acute vascular insufficiency of intestine diabetes with ketoacidosis, type i [juvenile type], uncontrolled 

Answer: The patient is high likely exposed to