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: lower gi bleeding major surgical or invasive procedure: (1) cardiac catheterization (2) right hemicolectomy, ileocolostoym, and repair of umbilical hernia history of present illness: this is a 62 year old female well-known to who presents with recurrent lower gi bleeding secondary to arterio-venous malformations. she is status-post several cauterization procedures by her gastroenterologist, dr. , most recently this past . she says her symptoms began nearly a year ago with multiple episodes of bright red blood per rectum and fatigue which was ascribed to anemia. several colonoscopies have revealed bleeding sites in the duodenum and cecum. most recently, she has noticed dark stools and dr. recommended surgical intervention. other than bloody stools, her has occasional right lower quadrant pain. she denies nausea/vomitting, constipation, or diarrhea. of note, her mother, grandmother, and aunt have a history of gi bleeding. past medical history: arterio-venous malformations diabetes hypertension hyperlipidimia coronary artery disease hypertrophic cardiomyopathy social history: the patient has a 35-pack history of smoking. she does not have a history of drinking alcohol. she has been on sick leave for over a year. family history: father- died of cirrhosis of the liver mother-- died of colon cancer at age 73 mother, maternal grandmother-- history of lower gi bleeding physical exam: on admission: 98.4, 81, 124/48, 18, 96% on room air gen: awake, alert, pleasant elderly female in no acute distress neuro: cn 2-12 grossly intact, no focal abnormalities heent: mmm, head atraumatic/normocephalic, perrla, eomi neck: no thyromegaly cv: regular rate and rhythm, holosystolic murmur pulm: clear to auscultation bilaterally abd: soft, nontender, non-distended, normoactive bowel sounds extr: warm, no edema pertinent results: serologies 08:30pm blood wbc-5.5 rbc-2.74* hgb-7.5* hct-23.4* mcv-86 mch-27.3 mchc-31.9 rdw-16.8* plt ct-201 05:32pm blood hct-28.2* 05:25am blood wbc-5.2 rbc-3.28* hgb-9.1* hct-27.4* mcv-84 mch-27.7 mchc-33.1 rdw-16.5* plt ct-174 05:28am blood wbc-5.1 rbc-3.65* hgb-10.1* hct-31.1* mcv-85 mch-27.7 mchc-32.6 rdw-16.7* plt ct-193 05:30pm blood wbc-10.1# rbc-3.64* hgb-10.0* hct-30.3* mcv-83 mch-27.4 mchc-32.9 rdw-16.5* plt ct-231 02:06am blood wbc-13.0* rbc-3.49* hgb-9.6* hct-29.1* mcv-84 mch-27.6 mchc-33.0 rdw-16.4* plt ct-232 02:43am blood wbc-10.2 rbc-3.54* hgb-9.6* hct-30.6* mcv-86 mch-27.1 mchc-31.4 rdw-15.8* plt ct-224 04:04am blood wbc-10.5 rbc-3.33* hgb-9.3* hct-28.2* mcv-85 mch-27.9 mchc-32.9 rdw-15.5 plt ct-257 04:24am blood wbc-5.2 rbc-3.62* hgb-10.3* hct-31.0* mcv-86 mch-28.3 mchc-33.1 rdw-15.2 plt ct-221 04:57am blood wbc-4.4 rbc-3.76* hgb-10.5* hct-32.4* mcv-86 mch-27.9 mchc-32.4 rdw-15.0 plt ct-226 08:30pm blood pt-13.1 ptt-27.3 inr(pt)-1.1 08:30pm blood glucose-179* urean-21* creat-0.7 na-141 k-4.1 cl-108 hco3-26 angap-11 05:30pm blood glucose-149* urean-9 creat-0.6 na-140 k-3.7 cl-111* hco3-22 angap-11 02:43am blood glucose-134* urean-4* creat-0.5 na-138 k-4.3 cl-106 hco3-28 angap-8 03:12am blood glucose-120* urean-7 creat-0.4 na-141 k-4.2 cl-104 hco3-30* angap-11 04:57am blood glucose-91 urean-8 creat-0.5 na-140 k-3.6 cl-104 hco3-30* angap-10 04:59am blood glucose-95 urean-9 creat-0.6 na-142 k-3.8 cl-103 hco3-30* angap-13 08:30pm blood alt-21 ast-21 alkphos-55 totbili-0.4 08:30pm blood albumin-4.2 calcium-9.7 phos-3.8 mg-2.0 iron-11* 05:10am blood albumin-3.8 iron-16* 05:00pm blood albumin-3.5 iron-24* 08:30pm blood caltibc-458 vitb12-341 folate-19.3 ferritn-4.6* trf-352 05:10am blood caltibc-412 trf-317 05:00pm blood caltibc-321 ferritn-67 trf-247 02:09pm blood glucose-125* lactate-0.9 na-138 k-4.0 cl-110 cardiology: catheterization: 1. selective coronary arteriography revealed a right dominant system without significant coronary artery disease. the lmca, lad, lcx and rca had mild luminal irregularities only and no flow limiting stenoses. of note, the first septal branch demonstrated "milking" in keeping with the patient's diagnosis of hypertrophic cardiomyopathy. 2. hemodynamics revealed that there was a significant gradient between the left ventricular apex and the left ventricular outflow tract. this was 100mm hg at rest and increased to 160mm hg with valsalva (with consequent fall in peripheral arterial pressure). there was a prominent spike and dome pattern seen on the aortic pressure tracings. after a ventricular premature beat, the tracings demonstrated the classic brockenbrough-braunwald sign (the peak systolic gradient increases after a vpc and the pulse pressure decreases - due to increased dynamic obstruction caused by the post extra-systolic potentiation). there was no gradient across the aortic valve. cardiac output was preserved. 3. left ventriculography demonstrated mid-cavity obliteration during systole. there was moderate-severe (3+) mitral regurgitation. overall ejection fraction was >80%. 4. the patient had an angioseal closure of the right femoral artery. microbiology blood culture: negative urine culture: negative catheter tip culture: negative radiology: cxr: small left pleural effusion brief hospital course: this is a 62 year old female with a one-year history of lower gi bleeding secondary to arteriovenous malformations in the cecum refractory to several cauterization treatments who presents for operative management. she was admitted on directly from her first surgical office visit when she was found to be quite anemic, with a hematocrit of 23.4. she was given 2 units of blood with appropriate rise in her hematocrit. she did not report any symptoms of gi bleeding during her hospital stay. of note, her pre-operative work-up included cardiac catheterization, as she was known to carry a history of hypertrophic obstructive cardiomyopathy. catheterization on revealed no coronary artery disease, but significant outflow obstruction through her aortic tract (please see full report details, below). she proceeded to the or on where she underwent a right hemicolectomy with ileo-colostomy and repiar of umbilical hernia. this procedure went without complication. she was transferred to the intensive care unit for close monitoring and was extubated without complication on post-operative day 1. she required some iv fluid boluses for low cvp but otherwise had no complications in the icu. her heart rate and blood pressure were well-controlled in the intensive care unit with lopressor and an esmolol drip, with goal settings for pulse in the 60s as recommended by cardiology and ct-surgery. she was transfused 2 units on post-operative day 2 for goal hematocrit above 30.0. she was started on clear liquids diet on post-operative day 4; she had some nausea but otherwise tolerated this well and was advanced to a soft diet on post-operative day 7. she was switched to po lopressor and started on po cardizem on post-operative day 8, which she tolerated well with pulse near the goal range of 60s-70s. she was discharged on post-operative day 9 in good condition, with planned follow-up with dr. within 2 weeks and dr. for discussion of eventual alcohol-ablation of her outflow obstruction. all questions were answered on discharged. medications on admission: iron sulfate 325 mg oral daily metoprolol 50 mg oral metformin 500 mg oral protonix 40 mg oral daily atorvastatin 10 mg oral daily multivitamins albuterol-ipratropium 2 puffs prn every 6 hours discharge medications: 1. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 2. diltiazem hcl 120 mg capsule, sustained release sig: one (1) capsule, sustained release po daily (daily). disp:*30 capsule, sustained release(s)* refills:*2* 3. hydrocodone-acetaminophen 5-500 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. disp:*100 tablet(s)* refills:*0* 4. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily). 5. metformin hcl 500 mg tablet sig: one (1) tablet po bid (2 times a day). 6. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 7. atorvastatin calcium 10 mg tablet sig: one (1) tablet po daily (daily). 8. albuterol-ipratropium inhalation 9. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). discharge disposition: home discharge diagnosis: (1) lower gi bleeding (2) hypertension (3) hypertrophic obstructive cardiomyopathy (4) diabetis mellitus (5) hypercholesterolemia discharge condition: good discharge instructions: please contact the office or come to the emergency room with any worsening abdominal pain, worsening nausea/vomitting, pain not improved with oral pain meds, shortness of breath or fatigue, fever > 101.0, drainage or redness at your incision. do not drive while taking narcotic pain medications. you may shower. leave your dressings on till your first office (you may remove your neck dressing on ). please call with any questions followup instructions: please contact the of dr. to set-up a follow-up appointment at a time of your convenience within 2 weeks: . please contact dr. (cardiology) to set-up a follow-up appointment within 2-3 weeks : provider: , . call to schedule appointment provider: , . call to schedule appointment procedure: venous catheterization, not elsewhere classified combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures open and other right hemicolectomy monitoring of cardiac output by other technique other open umbilical herniorrhaphy transfusion of packed cells diagnoses: pure hypercholesterolemia mitral valve disorders unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled iron deficiency anemia secondary to blood loss (chronic) personal history of tobacco use angiodysplasia of intestine with hemorrhage benign neoplasm of colon other specified congenital anomalies umbilical hernia with obstruction 

Answer: The patient is high likely exposed to