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: rectal bleeding major surgical or invasive procedure: colonoscopy with banding of bleeding ulcer history of present illness: pt is a 72 yo m with h/o large recto-sigmoid polyp, s/p recent colonoscopy on with multiple polyps identified s/p polypectomy who presents with 2 episodes brbpr today. patient has felt otherwise well post colonoscopy. this morning, he had 2 bloody bms with clot, as well as gell-like stool. he denies nausea, bloody emesis, or black stool (he takes iron). otherwise denies any change in his bowel habits, abdominal pain, cp or sob. he did feel slightly lightheaded after having these episodes. he has not had issues with bleeding in the past and notes no change in bruisability or excessive bleeding. he presented to an osh with a hct 28. because he received his colonoscopy at , he was transferred for further evaluation. of note, he was scheduled to have repeat colonoscopy in 3 months given concern for apc. also of note, he was scheduled to have recent pacemaker placement. . in the ed, hct 29. avss. ng lavage negative. transfusion was not given due to his stable hct. he was evaluated by gi who wishes to repeat his colonoscopy. . 10 point review of systems otherwise negative except those listed above past medical history: cad s/p cabg systolic chf, ef 20-25% type 2 diabetes mellitus htn hyperlipidemia ckd anemia of ckd social history: retired engineer. lifelong non-smoker. occational etoh, no recreational drugs. is otherwise independent family history: pancreatic cancer physical exam: vs: bp 120/57, hr 62, rr 12, 100%ra gen: cachectic but pleasant, nad heent: mm dry, eomi, anicteric sclera neck: supple no lad heart: rrr, soft 2/6 systolic murmur at llsb lung: ctab no wheezes or crackles abd: thin soft nt/nd + bs no rebound or guarding ext: warm, 1+ dp pulses, no pitting edema skin: no excessive rash or bruises neuro: no focal deficits pertinent results: admission labs: . 134 / 94 / 117 / 109 3.7 / 28 / 2.4 . ca: 9.4 mg: 2.8 p: 4.4. . alt: 32 ap: 239 tbili: 1.3 ast: 21 ldh: 190 . : lip: 196 dig: 1.8 . 7.1 \ 9.6 / 156 / 29.9 \ n:69.3 l:19.3 m:6.0 e:4.9 bas:0.6 . pt: 16.6 ptt: 37.9 inr: 1.5 . 06:30am blood wbc-5.7 rbc-3.15* hgb-8.9* hct-27.0* mcv-86 mch-28.2 mchc-32.9 rdw-18.1* plt ct-123* 05:30pm blood wbc-6.1 rbc-3.35* hgb-9.1* hct-27.8* mcv-83 mch-27.1 mchc-32.7 rdw-18.1* plt ct-146* 07:15am blood wbc-6.0 rbc-3.26* hgb-9.2* hct-27.4* mcv-84 mch-28.2 mchc-33.5 rdw-17.8* plt ct-138* 12:08pm blood wbc-6.6 rbc-3.26* hgb-9.2* hct-27.1* mcv-83 mch-28.3 mchc-34.1 rdw-17.8* plt ct-138* 05:01am blood wbc-6.4 rbc-3.10* hgb-8.9* hct-25.2* mcv-81* mch-28.7 mchc-35.2* rdw-17.9* plt ct-136* 11:58pm blood hct-26.9* 06:09pm blood hct-25.7* 04:40am blood wbc-6.7 rbc-2.98* hgb-8.0* hct-24.2* mcv-81* mch-26.9* mchc-33.1 rdw-17.9* plt ct-148* 04:40am blood wbc-6.7 rbc-2.98* hgb-8.0* hct-24.2* mcv-81* mch-26.9* mchc-33.1 rdw-17.9* plt ct-148* 09:50pm blood wbc-8.0 rbc-3.54* hgb-9.9* hct-28.6* mcv-81* mch-27.9 mchc-34.5 rdw-18.0* plt ct-159 05:50pm blood wbc-6.7 rbc-3.65* hgb-9.5* hct-29.3* mcv-80* mch-26.1* mchc-32.5 rdw-17.1* plt ct-158 05:50pm blood neuts-68.2 lymphs-20.4 monos-5.7 eos-4.9* baso-0.8 06:30am blood plt ct-123* 06:30am blood pt-15.6* ptt-36.8* inr(pt)-1.4* 05:30pm blood plt ct-146* 06:30am blood glucose-100 urean-86* creat-2.3* na-139 k-4.0 cl-102 hco3-25 angap-16 07:15am blood glucose-89 urean-86* creat-2.1* na-140 k-3.9 cl-101 hco3-26 angap-17 05:01am blood glucose-98 urean-91* creat-2.1* na-141 k-4.5 cl-103 hco3-24 angap-19 05:50pm blood glucose-98 urean-116* creat-2.3* na-135 k-3.5 cl-97 hco3-24 angap-18 03:48pm blood glucose-109* urean-117* creat-2.4* na-134 k-3.7 cl-94* hco3-28 angap-16 07:15am blood glucose-89 urean-86* creat-2.1* na-140 k-3.9 cl-101 hco3-26 angap-17 03:48pm blood alt-32 ast-21 ld(ldh)-190 alkphos-239* totbili-1.3 05:01am blood lipase-49 07:15am blood calcium-8.5 phos-3.6 mg-2.6 12:00pm blood osmolal-297 12:00pm blood cea-2.3 03:48pm blood digoxin-1.8 12:08pm blood lactate-1.6 studies: . ekg: lbbb at 79bpm with occational pvcs. no change compared to prior . colonoscopy () findings: contents: large amount of fresh red blood and clots were seen in the transverse colon, splenic flexure, descending colon, sigmoid colon and rectum. there was a small amount of dark liquid content in the ascending colon and cecum which was completely suctioned. excavated lesions a single ulcer was found in the cecum at the old polypectomy site which had a clean base. it was flushed with water and no active bleeding source was identified. a small ulcer was found in the splenic flexure at the old polypectomy site without active bleeding. careful visulization of the colon was performed after flushing/suctioning with water during withdrawl of the colonoscope. a small ulcer with visible vessel was noted at 18cm from anal verge the site of the large emr. active bleeding was noted from this site. five endoclips were applied for the purpose of hemostasis at the base of this bleeding site at 18cm. 10 cc. of total epinephrine 1/ injection were applied for hemostasis at the base of the polypectomy site with good hemostasis at the end of the procedure. the area was flushed with water and no further active bleeding was seen. . impression: active bleeding was noted from ulcer with visible vessel at polypectomy site at 18 cm from anal verge. hemostasis was achieved using endoclips and epinephrine. brief hospital course: 72m with cad s/p cabg, chf, dm2 who presents with brbpr after recent colonoscopy with multi-polypectomies, hct stablized with no further episodes of bleeding. . # gi bleeding: red blood per rectum most consistent with a lower source, and his recent polypectomy would predispose to bleeding -- however, it has been ~2 weeks since the procedure. he received 3 units of prbcs, 1 unit of ddavp, 1 unit ffp and oral vitamin k for inr 1.6 and hematocrit drop 28.6 to 24.2. patient had a colonoscopy here that noted active bleeding from an ulcer with visible vessel at polypectomy site at 18 cm from anal verge. hemostasis was achieved using endoclips and epinephrine. his hematocrit was stable for 72 hours after the colonoscopy without the need for any further transfusions. he was transferred to the floor where his hematocrit remained stable. he was advanced to a regular diet which he tolerated without difficulty. . on the day of discharge, , he was instructed to restart his aspirin in 7 days. he will follow-up with his pcp days to have his cbc checked. he will need to have repeat colonoscopy within 2-3 months, which will be arranged by the gi service (dr. . pt was provided with his phone number in case he does not receive notification. he was instructed to continue colace, senna, and miralax prn for constipation while on iron. . # cad s/p cabg: stable, ekg unchanged. in the icu, patient's asa and beta blocker were held in the setting of bleeding. once hemodynamically stable, the beta blocker was restarted. his aspirin should be restarted 7 days after his discharge as per gi. . # chronic systolic chf: on admission to the icu, patient appeared euvolemic. beta blockers, statin, diuretics, digoxin and asa were initially held in the setting of bleeding. signs of volume overload were monitored given added volume from blood products. at the time of discharge all of the above medications were restarted, with the exception of aspirin (as above), and metolazone. pt was instructed to weigh himself daily, and restart metolazone if his weight increased >2lb/day. otherwise, he was instructed to follow-up with his pcp 7-10 days. . # anion gap: improved over icu course, likely due to renal failure. patient may be intravascularly contracted. patient had a normal lactate (1.6) so unlikely lactic acidosis. serum osmolality was normal. gap is likely from uremia. patient was mentating well and does not appear tachypneic. his gap closed with hydration. . # coagulopathy: no history of liver disease, not on warfarin; though to be nutritional. he was treated with oral vitamin k for 3 days with improvement to inr 1.4. . # hyperlipidemia: pt continued on home regimen of statin. . # type 2 diabetes, controlled: glipizide was held and he was covered with a hiss in house with good control. his glipizide was restarted upon discharge. . # ckd: baseline appears to be around 2.5. on the day of discharge, cre = 2.3. he was instructed to have his chem7 (including bun/cre) checked in days as he has restarted his home regimen of lasix/potassium. . # anemia of ckd: epogen and iron supplements were continued. . # full code medications on admission: atorvastatin 40mg daily asa 81mg daily carvedilol 12.5mg digoxin 125mcg daily epoetin lasix 80mg daily glipizide 5mg metolazone 5mg 3/week qmwf kcl 8 meq 3/week vitamin c 500mg daily ferrous sulfate 325mg mvi daily colace discharge disposition: home discharge diagnosis: primary: lower gi bleeding from polypectomy site secondary: chronic systolic heart failure coagulopathy chronic renal insuficiency diabetes, type 2, controlled discharge condition: tolerating oral diet, stable red blood cell count. discharge instructions: you were admitted to the hospital with rectal bleeding. you underwent colonoscopy which revealed a bleeding ulcer in the colon. this was treated with clipping. you were treated with 3 units of blood. your blood count remained stable for 72 hours after transfusion. . the following changes were made to your medication regimen: 1. your aspirin was held. this may be restarted 1 week after discharge. 2. your metolazone was held. you should weigh yourself daily, and restart this medication if your weight increases by >2lb/day. you should follow-up with your pcp 7-10 days of your discharge, to have labs checked. . if you have recurrent symptoms of rectal bleeding, lightheadeness, dizziness, fevers, chills, worsening abdominal pain, or other worrisome symptoms, please contact your primary care physician or the emergency department. followup instructions: please contact your primary care physician upon your arrival home, and arrange for a follow-up appointment within 7-10 days. you should have your creatinine and blood count checked at that visit. . you will need to follow-up with the dr. , to have a colonoscopy within 3 months. his office will call you with an appointment. please call his office at ( if you have not heard from them within 2 months. procedure: endoscopic destruction of other lesion or tissue of large intestine diagnoses: anemia in chronic kidney disease congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status chronic kidney disease, unspecified hemorrhage complicating a procedure other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure chronic systolic heart failure accidents occurring in other specified places ulceration of intestine ulcer of anus and rectum 

Answer: The patient is high likely exposed to