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: penicillins attending: chief complaint: light-headedness, dizziness, anemia major surgical or invasive procedure: egd history of present illness: 70 year old female with a history of remote peptic ulcer disease 30 years ago, htn, cva who presents with hematemesis and hypotension. patient noted diarrhea/melena, lightheadedness beginning 3 days prior to admission. she had no abdominal pain. today, patient vomited blood and then clear liquids. went to her pcp where she was noted to have systolic blood pressure in the 80s, chills, clammy skin. in the ed her blood pressure was 79/31, hr 93, hypotehrmic 94.1. received 2 lns with stabilization of bp. nasogastric lavage was negative for bright red blood. stool was black and guiac positive. patient denies use of nsaids but does take asa daily. of note, patient has had recent weight loss, and was found to be hyperthyroid. recent thyroid scan showed disease(diffuse uptake). ros: no h/a, no fever, chills, diarrhea, n/v, weight loss, no dysuria, no new weakness/numbness. past medical history: pmh: 1. cva w/ residual left sided weakness, right facial numbness, dysphagia 2. htn 3. h/o remote pud social history: no tobacco, no alcohol. has one grand daughter with a child who lives in town. of italian origin and primarily italian speaking. family history: nc physical exam: vs 97.3, hr 87, bp 126/70, rr 26, sao2 97% ra i/o=460/700 gen: nad, pale, pleasant heent: perrl, eomi, dry mm neck: thyromegaly, no nodules, no lad cv: tachycardic with a normal s1 s2, no m/r/g lungs: cta b/l, no wheezes, ronchi or rales abd: soft, nt, nd, bs+. no hsm ext: no edema, some hyperpigmentation neuro: aaox3, moving all extremities pertinent results: 09:45pm plt count-247# 05:28pm glucose-124* urea n-33* creat-0.7 sodium-144 potassium-3.3 chloride-108 total co2-31* anion gap-8 05:28pm alt(sgpt)-22 ast(sgot)-21 alk phos-58 tot bili-0.4 05:28pm calcium-8.4 phosphate-2.7 magnesium-1.5* iron-70 05:28pm caltibc-346 ferritin-107 trf-266 05:28pm tsh-0.34 05:28pm t4-13.9* 05:28pm plt count-105*# 03:15pm urine color-straw appear-clear sp -1.008 05:28pm neuts-79.6* lymphs-17.8* monos-1.9* eos-0.6 basos-0.1 03:15pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.5 leuk-neg 12:55pm glucose-143* urea n-42* creat-0.7 sodium-141 potassium-3.5 chloride-103 total co2-30* anion gap-12 12:55pm wbc-14.3* rbc-2.56* hgb-7.4* hct-21.5* mcv-84 mch-29.0 mchc-34.4 rdw-14.0 12:55pm neuts-85.1* lymphs-13.4* monos-1.3* eos-0.1 basos-0.2 12:55pm plt count-272 . . cxr: findings: the cardiac and mediastinal silhouettes are within normal limits. there are no focal pulmonary opacities, pleural effusions, or evidence of pneumothorax. there is prominence of right pericardial fat pad. there is osteopenia. . . ekg: sinus rhythm at 92 bpm. scooping of the st segments in lead ii and leads v5-v6 in a recording that is technically limited. these findings are non-specific. . . egd results: impression: 1. ulcer in the duodenal bulb. 2. erosions and erythema in the stomach body compatible with gastritis. 3. erythema in the duodenal bulb compatible with duodenitis. recommendations: 1. protonix 40 mg twice daily 2. check h. pylori serology and treat with triple antibiotic therapy if positive 3. clear liquid diet and advance as tolerated. brief hospital course: 1. gib -- the patient was placed on an iv ppi . two large bore ivs were maintained throughout her stay. she was initially transfused 2 units of packed red blood cells with appropriate increases in her hematocrit. hematocrits were checked q 6 hours in the icu for hosptial days #1 and 2. then on the floor for hosptital days 3 and 4. egd was performed on hospital day #2 with the above results. she was switched to po protonix prior to discharge and was tolerating a regular diet. 2. thyroid -- recently dxed may have been contributing to her tachycardia, she remained tachy to the low 100's until hospital day #3 when she was started on metoprolol 12.5 . her heart rate then decreased to the 80s-90s. she will likely need an endocrine consult as an outpatient. 3. htn -- blood pressure medications were initially held then metoprolol 12.5 was started. her blood pressure remained stable on the floor and was 120/70 just prior to discharge. 4. heme -- her hematocrit responded appropriately to blood transfusion and remained stable ~ 28, then increased to 30.8 in the day and half prior to discharge. medications on admission: 1. asa, 2. cymbalta, 3. moexipril/hctz discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 2. duloxetine 30 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po daily (daily). 3. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 4. metoprolol tartrate 25 mg tablet sig: one half tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: gib discharge condition: fair discharge instructions: if you feel light headed, dizzy, experience any black or tarry stools, vomit blood or coffee ground - like material, please call your doctor or return to the emergency department immediately. please take all of your medications as instructed, especially protonix (pantoprazole) which will protect your stomach. followup instructions: please follow up with dr. your primary care doctor within 1 week. call to schedule an appointment with him. procedure: other endoscopy of small intestine transfusion of packed cells diagnoses: unspecified essential hypertension chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction duodenitis, without mention of hemorrhage toxic diffuse goiter without mention of thyrotoxic crisis or storm unspecified gastritis and gastroduodenitis, without mention of hemorrhage 

Answer: The patient is high likely exposed to