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 / raloxifene / morphine / fosamax / donepezil hcl / ace inhibitors attending: chief complaint: lightheadedness, fatigue major surgical or invasive procedure: egd colonoscopy history of present illness: ms. is an 84 year old woman with a hx of cad, htn, arthritis who presents with symptomatic bradycardia. the patient awoke this morning feeling at 4am feeling unwell with nausea, dizziness and lightheadedness. she denies chest pain, palpitations, shortness of braeth, chest pressure/tightness. she called ems. . per ems, bp was 60/p with hr of 38 on arrival. she was given atropine 0.5mg iv x 2 with improvement of hr to the 40s and bp to 80s-100s systolic. . in the ed, initial vitals were hr50 bp100/60 rr18 100% on ra. she was given 1mg atropine x 1 in the ed. ecg showed junctional rhythm with retrograde p waves. external pacing was done for 1 minute as bp was low (90s) and rhythm spontaneously converted to sinus. the patient was also given glucagon 1mg and calcium gluconate. she was given fentanyl 25mcg while being externally paced. on rectal exam she was noted to have dark guaiac positive stool. she was given 40mg iv protonix and gi was consulted. she was typed and crossed for 2 units. . on arrival to the floor, she denies any symptoms of dizziness, lightheadedness, chest pain, palpitations, abdominal pain. she had an episode of diarrhea a few days ago. she occasionally has red/brown stools, the last time was a few weeks ago and she denies any currently. she does not know why she is on cipro or cephalexin. she is somewhat confused due to fentanyl given to her in the ed. she states that she may occasionally make mistakes regarding her medications. she does not use a pill box. per her son, she has been more foregetful lately. the patient lives alone. . per conversations with her pcp, has a history of gastritis/colitis and was due to have a colonoscopy which she did not show for. . on review of systems, she denies recent fevers, chills or rigors. cardiac review of systems as per hpi. positive for rash on the legs and arms which was puritic in nature. all of the other review of systems were negative. . past medical history: tias - tia - tia after being off plavix for 4 days; mra head/neck showed short segment of r pca stenosis cad - q waves seen on past ecgs - echo hk in inferolateral wall - echo ak in basal posterior wall; worsening hk in inferolateral wall; ef 65% - - stress test ischemic st changes in inferior and lateral walls hyperlipidemia htn total knee replacement depression arthritis iron deficiency anemia; baseline hct 34 for past 7 months gastritis s/p gastric ulcers on egd ? ischemic colitis; was due for colonoscopy but pt social history: she is married; her husband lives in a nursing home and the patient lives alone. she has 1 son who lives in and she has 1 daughter. she does not smoke cigarettes and drinks a glass of wine every so often. family history: mother died of congestive heart failure. father had bladder cancer. there is no family history of colon cancer. physical exam: vs: t=97.4 bp 124/43 hr 60 rr 23 99% on 2l nc general: elderly woman, nad. oriented x 1 (knew hospital but not name, thought date was ). heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck: supple with jvp of 5 cm. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. ctab, no crackles, wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ pertinent results: cxr : 1. large hiatal hernia. 2. no acute cardiopulmonary abnormality. admission labs 03:00pm blood wbc-8.2# rbc-4.36 hgb-9.5* hct-32.9* mcv-75* mch-21.7* mchc-28.8* rdw-17.4* plt ct-290 02:30am blood wbc-6.7 rbc-3.38* hgb-7.5* hct-25.4* mcv-75* mch-22.1* mchc-29.5* rdw-17.0* plt ct-215 03:00pm blood pt-11.7 ptt-22.5 inr(pt)-1.0 02:30am blood glucose-81 urean-19 creat-0.6 na-142 k-4.0 cl-111* hco3-26 angap-9 03:00pm blood ck(cpk)-144 09:02pm blood ck(cpk)-97 02:15am blood ck(cpk)-99 02:30am blood ck(cpk)-89 03:00pm blood ctropnt-<0.01 09:02pm blood ck-mb-notdone ctropnt-<0.01 02:15am blood ck-mb-notdone ctropnt-<0.01 02:30am blood ck-mb-notdone ctropnt-<0.01 03:00pm blood calcium-9.1 phos-4.4 mg-2.4 03:00pm blood tsh-3.9 egd large hiatal hernia erythema in the antrum multiple erosions in the duodenal bulb compatible with duodenitis normal mucosa in the second part of the duodenum (biopsy) otherwise normal egd to third part of the duodenum colonscopy diverticulosis of the throughout the colon otherwise normal colonoscopy to cecum brief hospital course: ms. is an 84 year old woman with a hx of tias, cad, htn, iron-deficiency anemia who presents with symptomatic bradycardia. . #. bradycardia: patient was found to be in a junctional rhythm on arrival to ed. her bradycardia was thought to be secondary to improper dosing of her beta-blocker and verapamil in the setting of acute renal failure (hypovolemia, gi bleed). these medications were held with resulting improvement in her heart rate, though there may be a component of sinus node dysfuction. ecg did not show st segment changes and cardiac enzymes were negative ruling out an ischemic cause of her symptoms. while in the ccu, she did not require atropine or dopamine. the patients symptoms resolved and she remained in sinus rhythm at a normal rate. she was transfered to the floor and started on a low dose of metoproplol tartate. . #. gi bleed: patient was guaiac positive on exam and iron studies c/w severe iron deficiency. she required 2u prbc's in the ccu for a hct of 25.4 in the context of lower blood pressures. she was continued on protonix 40mg iv bid and remained npo. gi recommended ng lavage, but very worried about vagal stimulation. the patient received egd/colonoscopy that showed duodenitis and diverticulosis. she will need to be maintained on protonix outpatient. . # acute renal insufficiency: patient with cr of 1.0 on admission, clinical exam supported poor intravascular status (poor po and gi bleed). she was given ivf's with improvement in her clinical appearance and a repeat cr of 0.6. . #. coronary artery disease: unclear history. per pcp, has q waves on ecg but no prior caths or stents. she has been on plavix as an outpatient for h/o tias, but has not been on aspirin. in the context of bradycardia, her beta-blocker was initially held. she was restarted on metoprolol prior to discharge. . #. history of multiple tias: patient to continue on plavix. . # ?dementia: patient with waxing & agitation/confusion during ccu stay. patient lives alone and reports being able to manage her medications and adl's independently. she has fired vna on multiple occasions in the past per pcp. saw patient and recommended rehab that patient refused. ot reccommended 24 hour supervision but recognized that if the patient refuses that there is a middle ground. her mental status waxed and waned, however by hd#3, she was mentating very well. in the ed, she had received large doses of atropine and fentanyl which could precipitate delirium. there was a family meeting involving the patient's daughter and social work for placement for rehab. . #. rash: patient reportedly placed on po prednisone by dermatologist for rash after failing topical therapy, but etiology of rash is unclear and plan for taper unknown. admitted on 10mg po prednisone, but this was held in the setting of possible gi bleed. she was started on sarna lotion with good effect. . medications on admission: benicar 20 mg tab oral ciprofloxacin 250 mg tab oral, - pcp and patient do not know indication, pt states she has been taking for years prednisone 10 mg tab oral - pt states she has been taking for 2 weeks for rash cephalexin 500 mg cap oral, 1 capsule(s) three times daily - pt does not know indication atenolol 12.5 mg tab oral paroxetine 20 mg tab oral plavix 75 mg tab oral pravastatin 40 mg tab oral verapamil sr 180 mg tab oral zantac 150mg po bid flonase prn glaucoma eye drop discharge medications: 1. losartan 50 mg tablet sig: one (1) tablet po daily (daily). :*30 tablet(s)* refills:*0* 2. pravastatin 40 mg tablet sig: one (1) tablet po at bedtime. 3. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 4. paroxetine hcl 20 mg tablet sig: one (1) tablet po daily (daily). 5. flonase 50 mcg/actuation spray, suspension sig: one (1) nasal twice a day as needed for allergy symptoms. 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours): please discuss with primary care physician. :*60 tablet, delayed release (e.c.)(s)* refills:*0* 7. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po daily (daily). :*30 tablet(s)* refills:*0* 8. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). :*60 capsule(s)* refills:*0* 9. timolol maleate 0.5 % drops sig: one (1) drop ophthalmic (2 times a day). 10. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical (2 times a day) as needed for itching. 11. metoprolol succinate 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. 12. benicar 20 mg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: - discharge diagnosis: primary diagnosis: 1. symptomatic bradycardia 2. duodenitis secondary diagnosis: 1. hypertension 2. hyperlipidemia 3. iron deficiency anemia 4. coronary artery disease 5. history of tia 6. depression discharge condition: mental status:confused - sometimes level of consciousness:alert and interactive activity status:ambulatory - independent discharge instructions: you were admitted for a slow heart rate. you were given medications to help speed up your heart and had to be externally paced. it is likely that this happened because you took to many of your high blood pressure medications at once. be careful to take you medications as directed in the future. you were also found to have some blood in your stool. you had a endoscopy and colonoscopy to evaluate the site of bleeding. it was found that you had some irritation of your duodenum. a biopsy was taken but the results are pending. this will need to be followed by your primary care physician. are being discharged to a rehab facility. the following changes were made in your medications: 1. stop atenolol 2. stop verapamil 3. stop ciprofloxacin 4. stop cephalexin 5. start metoprolol succinate 25mg by mouth daily 6. start pantoprazole 40mg by mouth twice a day 7. stop zantac 150mg by mouth twice a day 8. start sarna lotion apply as needed for your itch followup instructions: md: dr. specialty: pcp / time: wednesday, at 11:15am location: , route 9, , phone number: md: dr. specialty: gastroenterology date/ time: thursday, at 9:15am location: , bldg , ma phone number: procedure: colonoscopy esophagogastroduodenoscopy [egd] with closed biopsy diagnoses: coronary atherosclerosis of native coronary artery unspecified essential hypertension acute posthemorrhagic anemia acute kidney failure, unspecified depressive disorder, not elsewhere classified other persistent mental disorders due to conditions classified elsewhere diaphragmatic hernia without mention of obstruction or gangrene other and unspecified hyperlipidemia other specified cardiac dysrhythmias rash and other nonspecific skin eruption personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits duodenitis, without mention of hemorrhage hemorrhage of gastrointestinal tract, unspecified encephalopathy, unspecified hypovolemia knee joint replacement diverticulosis of colon (without mention of hemorrhage) arthropathy, unspecified, site unspecified poisoning by other and unspecified agents primarily affecting the cardiovascular system accidental poisoning by agents primarily affecting cardiovascular system 

Answer: The patient is high likely exposed to