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: no known allergies / adverse drug reactions attending: chief complaint: syncope, upper gi bleed major surgical or invasive procedure: mechanical ventilation egd x 2 intubation history of present illness: micu hpi: this is a 48-year-old man with a history of chronic hcv, traumatic brain injury, who was visiting his psychiatrist dr. on the for a scheduled visit when he had a syncopal episode. code team responded. he was noted to have bps in 70s, hr 130s, fs of 207 and was brought to ed. here, he denied any pain (though he was felt to be an unreliable historian), but did endorse dizziness prior to falling to the ground. he received 2l of ns. labs were notable for hct of 19. he denied any dark stools, nausea, vomiting, hematemesis, brbpr, or abdominal pain. upon arrival to the ed vitals were: t 97.4, hr 130, bp 90/56, rr 20, o2 sat 98% 4l. ng lavage was performed after noting the hct and returned frank blood. patient removed his own ngt and refused replacement. also pulled out an iv in the ed. his exam was notable for distended belly, guaiac negative. the liver team was contact as he is followed here for his hcv, and recommended starting protonix gtt which was done in the ed. medicine hpi: 48m with dm, bipolar disorder, and hcv who syncopized at his psychiatrists office and was taken to the ed. in the ed he was found to have an h/h of 7.2/19.6 from a baseline of 13.6/37.9. he was admitted to the micu where he received a total of 5 units of prbc. he underwent egd which revealed tear. the lesion was clipped, local hemostasis was achieved, and his h/h stabilized. . on questioning, he denies any history of gerd, gastritis, ugib, lgib, swallowing foreign objects, pills stuck in his throat, easy bleeding or bruising as with brushing his teeth or normal activities. he did vomit x 2 on sunday after going to . he denies any diarrhea or fever, sick contacts, or a history of recurrent vomiting. he says when he went to his psychiatrists office he felt weak and shaky like a "head rush" and the next thing he remembers he was in the ed. . at this time he feels well and is hungry. he has no other complaints. . review of systems: (+) per hpi (-) review of systems: gen: no fever, chills, night sweats, recent weight loss or gain. heent: no headache, sinus tenderness, rhinorrhea or congestion. cv: no chest pain or tightness, palpitations. pulm: no cough, shortness of breath, or wheezing. gi: no nausea, vomiting, diarrhea, constipation or abdominal pain. no recent change in bowel habits, no hematochezia or melena. gui: no dysuria or change in bladder habits. msk: no arthritis, arthralgias, or myalgias. derm: no rashes or skin breakdown. neuro: no numbness/tingling in extremities. psych: no feelings of depression or anxiety. all other review of systems negative. past medical history: - type ii diabetes - diabetic neuropathy on gabapentin - hcv: genotype 1, biopsy with features c/w chronic viral hepatitis c with grade 2 inflammation and stage 3 fibrosis; per liver clinic note has chronically elevated transaminases - coronary artery disease s/p stent placement (~, ) - traumatic brain injury (~5 years ago) - dementia believed to be due to tbi - bipolar disorder on seroquel and fluphenazine and venlafaxine social history: - lives with caretaker. mother and sister in . goes to day program tuesday to friday. - tobacco: 1ppd, started age 18 - etoh: per notes at times smells of etoh, but pt denies, heavy drinking in the past, supposedly sober since the 80s - illicits: in the past, sober by report since the 80s family history: - father: died age of 56, he is uncertain as to the cause of death - mother: alive and well in physical exam: micu: gen: awake in bed, wdwn milddle aged man, responding to questions, nad heent: conjunctiva slightly pale, pupils reactive, eomi neck: no jvd, supple pulm: cta bilaterally card: tachycardic to ~100s, no m/r/g abd: mildly distended with bowel gas to percussion, nt, soft, +bs, no rebound/guarding ext: no edema skin: clear neuro: oriented to place , date psych: somewhat flat affect, poor insight during history taking medicine admission: vs: t 98.6 p 87 bp 132/84 r 20 96% on room air gen: aox3, nad heent: mmm, no jvd, neck supple, no cervical, supraclavicular, or axillary lad cards: rr s1/s2 normal, no murmurs/gallops/rubs pulm: no dullness to percussion, ctab no crackles or wheezes abd: bs+, soft, nt, no rebound/guarding, no hsm limbs: no le edema, no tremors or asterixis skin: no rashes or bruising, many tattoos neuro: grossly nonfocal discharge: gen: nad, pleasant vs: t 98.1 tm 98.6 p 88(78-91) bp 132/80 (123-152/68-86) r 20 96% on ra heent: mmm, no op lesions, no lad, jvp not elevated cv: rr, no mrg pulm: ctab with bibasilar crackles abd: bs+, ntnd, no hsm limbs: no le edema, no tremors or asterixis neuro: grossly nonfocal pertinent results: admission: 11:12am blood wbc-13.9*# rbc-2.02*# hgb-7.2*# hct-19.6*# mcv-97 mch-35.8* mchc-36.9* rdw-13.8 plt ct-265 01:30pm blood pt-14.2* ptt-31.1 inr(pt)-1.2* 11:12am blood glucose-170* urean-42* creat-1.4* na-131* k-4.5 cl-99 hco3-21* angap-16 04:16am blood calcium-8.3* phos-2.1* mg-1.8 discharge: 05:40am blood wbc-5.4 rbc-3.39* hgb-11.2* hct-30.7* mcv-90 mch-33.0* mchc-36.5* rdw-16.1* plt ct-174 05:40am blood pt-12.0 ptt-26.7 inr(pt)-1.0 05:40am blood glucose-109* urean-10 creat-0.8 na-135 k-4.0 cl-104 hco3-27 angap-8 05:40am blood calcium-8.4 phos-3.6 mg-1.7 hct trend: 11:12am blood hct-19.6*# 04:00pm blood hct-23.3* 10:31pm blood hct-24.8* 04:16am blood hct-29.0* 07:43am blood hct-30.2* 02:43pm blood hct-29.1* 12:05am blood hct-29.5* 05:40am blood hct-30.7* brief hospital course: 48m with hcv, dm, s/p traumatic brain injury, and bipolar disorder who presented with syncope and was found to have a tear of the esophagus which was successfully clipped. his h/h has stabilized and he did well clinically. he was dced to home with close follow up. # syncope: due to bleeding. treated as below. orthostatics negative. defered additional syncope work up as an obvious cause has been identified. # tear: seems to be from his history of recent vomiting. it is not entirely clear why he developed this. gi followed and interevened in the micu. held off on ppi at dc per gi as no obvious gastritis. # diabetes: pt report taking insulin glargine 80 units sq hs, but did no require nearly this much insulin. discharged on insulin glargine 20 units sq hs and hiss with pcp follow up. # cad: review of records shows cad s/p stending in . unclear if on outpatient asa. given recent bleed, held off on restarting and will defer to pcp. # acute kidney injury: on admission had creatining of 1.4 mg/dl. improved to baseline of 0.9 mg/dl s/p ifv and blood. # hcv: genotype 1, biopsy with features c/w chronic viral hepatitis c with grade 2 inflammation and stage 3 fibrosis; per liver clinic note has chronically elevated transaminases. no evidence of decompensated liver disease so will hold off on ppx abx s/p gib. . # bipolar disorder: continued home quetiapine fumarate 400 mg po/ng qam, quetiapine fumarate 500 mg po/ng qhs, venlafaxine xr 75 mg po daily, and fluphenazine 10 mg po qhs. micu course: this is a 48-year-old man with a history of chronic hcv and traumatic brain injury who was found to have hct of 19 with frank blood in the stomach after a syncopal episode at a routine doctor's visit. . # syncope: likely secondary to orthostasis from blood loss given drop in hematocrit. egd demonstrated tear in the esophagus with overlying clot. lesion was clipped by gi with excellent hemostasis. patient was transfused 5 units and hematocrit rose to 30.2. patient had also improved symptomatically, and reported no dizziness or palpitations. he had no more episodes of vomiting or hematemesis. mr. remained on telemetry overnight. . #. low hematocrit/gi bleed: likely from tear as seen on egd. as above, hemostasis was acheived with clipping and patient had no more episodes of hematemesis. he was transfused 5 units and remained hemodynamically stable. he was originally placed on octreotide and ppi drip, both of which were discontinued after the results of the egd. . #. airway protection: patient was intubated for airway protection due to large amounts of blood. he was successfully extubated after the egd. . #. acute renal failure: likely pre-renal in setting of gi bleed. creatinine resolved with stabilization of hemodynamics. . #. hepatitis c: managment deferred to outpatient providers. . #. diabetes: patient with type ii dm and hgba1c of 13.2% in . insulin sliding scale was initiated while patient was admitted. . #. psychiatric issues, traumatic brain injury: per psychiatric notes, patient has carried multiple diagnoses including bipolar disorder and schizoaffective disorder. he has a history of impulsivity since childhood, now compounded by traumatic brain injury/early dementia. psychiatric medications were continued once patient was able to take pos. medications on admission: - type ii diabetes - chronic hepatitis c virus (biopsy with features c/w chronic viral hepatitis c with grade 2 inflammation and stage 3 fibrosis; per liver clinic note has chronically elevated transaminases) - coronary artery disease s/p stent placement (~, ) - traumatic brain injury (~5 years ago) discharge medications: 1. seroquel 400 mg tablet sig: one (1) tablet po qam. 2. seroquel 400 mg tablet sig: one (1) tablet po at bedtime: with 100 mg pill for total of 500 mg at bedtime. 3. seroquel 100 mg tablet sig: one (1) tablet po at bedtime: with 400 mg pill for total of 500 mg at bedtime. 4. gabapentin 300 mg capsule sig: three (3) capsule po tid (3 times a day). 5. fluphenazine hcl 10 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 6. venlafaxine 75 mg capsule, ext release 24 hr sig: one (1) capsule, ext release 24 hr po daily (daily). 7. insulin glargine 100 unit/ml (3 ml) insulin pen sig: twenty (20) units subcutaneous at bedtime. 8. humalog kwikpen 100 unit/ml insulin pen sig: 2-10 units subcutaneous as directed by your sliding scale. discharge disposition: home discharge diagnosis: primary - tear secondary: - type ii diabetes - diabetic neuropathy on gabapentin - hcv: genotype 1, biopsy with features c/w chronic viral hepatitis c with grade 2 inflammation and stage 3 fibrosis; per liver clinic note has chronically elevated transaminases - coronary artery disease s/p stent placement (~, ) - traumatic brain injury (~5 years ago) - dementia believed to be due to tbi - bipolar disorder on seroquel and fluphenazine and venlafaxine discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: it was a pleasure taking care of you at . you were admitted for syncope (passing out). we found that the reason you passed out was very low blood counts. we did an endoscopy (special study of your esophagus) to find your source of bleeding and identified a tear in your esophagus. we repaired the bleeding vessel and you improved. if you vomit it is very important that you call your doctor so that you do not develop another tear in your esophagus. medication changes: - reduce glargin insulin (lantus) to 20 units at bedtime - continue your humalog insulin sliding scale as you have been doing - continue your other medications as you have been taking them followup instructions: name: , m. address: , , phone: appt: at 11am department: cognitive neurology unit when: tuesday at 9:00 am with: , md building: ks building (/ complex) campus: east best parking: main garage department: liver center when: tuesday at 4:00 pm with: dr. building: lm campus: west best parking: garage procedure: other endoscopy of small intestine endoscopic excision or destruction of lesion or tissue of esophagus diagnoses: anemia, unspecified cirrhosis of liver without mention of alcohol chronic hepatitis c without mention of hepatic coma acute kidney failure, unspecified diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes percutaneous transluminal coronary angioplasty status other persistent mental disorders due to conditions classified elsewhere long-term (current) use of insulin bipolar disorder, unspecified gastroesophageal laceration-hemorrhage syndrome personal history of traumatic brain injury 

Answer: The patient is high likely exposed to