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: protamine attending: chief complaint: right lower extremity pain and swelling major surgical or invasive procedure: picc line placement by ir fistulagram by ir history of present illness: ms is a 80 yo female with mechanical avr, multiple episodes of gi bleed and hemicolectomy gib, who recently () was started on an unclear dose of lovenox to bridge her anticoagulation for colonoscopy. yeaterday patient started having right lower extremity pain. today she went for her hemodialyis, where she was found to have extensive right thigh swelling. without undergoing dialysis she was send to ed for further evaluation and treatment. currently she denies any lightheadedness, chest pain, or sob but endorses significant pain and discomfort in her right lower extremity w/o being able to ambulate or move actively. she denies any history of recent trauma to this site and endorses a spontaneous appearance. past medical history: 1. repeated hx of gastrointestinal bleeding (most recent ) 2. left hemicolectomy with transverse colostomy for gib 3. diastolic chf (ef 65-75%) 4. status post tracheostomy placement after prolonged intubation in icu (at time of colectomy) - removed 5. severe as s/p mechanical avr 6. hypertension 7. elevated cholesterol 8. diabetes type 2 9. end-stage renal disease on hd mwf 10. bilateral total knee replacment 11. multiple skin lesions removed by general and plastic surgery 12. hypothyroidism 13. presumptive history of atrial fibrillation; on amiodarone social history: lives at home with husband, and son. children in the area. is a non-smoker, no alcohol use, no history of illicit drug use. retired, former manager family history: no colon ca, otherwise unremarkable physical exam: initial physical exam vs: t 97 bp 224/110 hr 54 rr 18 o2 99ra fs 186 gen:the patient is in obvious pain skin:no rashes or skin changes noted. heent: no jvd, neck supple . oropharynx clear without lesions or exudates. no lymphadenopathy in cervical, posterior, or supraclavicular chains noted. chest:lungs are clear without wheeze, rales, or rhonchi. cardiac: regular rhythm; 3/6 sem rusb,no rubs, or gallops. abdomen: non tender, not destended, colostomy bag semi filled, no erythema or discharge extremities: 1+ , right thigh with bulging hematoma from iliac creast on lateral aspect neurologic: alert, oriented x3 and appropriate. bue , and lle rle sensation preserved, toe strength 5/5 bl vs: 99.3 108/palp 88 16 on discharge: ext: right thigh ~57cm in diameter, some tenderness on palpation, l antecubital fossa- thrill palpable, murmur audible on av fistula. pertinent results: initial cbc: 02:50pm wbc-5.2 rbc-3.49* hgb-10.8* hct-33.7* mcv-97 mch-31.0 mchc-32.1 rdw-17.7* initial chem 7 02:50pm glucose-165* urea n-62* creat-7.7*# sodium-135 potassium-5.8* chloride-95* total co2-28 anion gap-18 imaging: 1. no evidence of dvt in the right lower extremity. 2. large presumed hematoma deep to the right thigh muscles, extending along the femur, medially and laterally. recommend clinical correlation. 3. limited arterial interrogation revealed limited absent diastolic flow. * r femur xray: diffuse osteopenia, status post orif distal femoral fracture and three-component arthroplasty, without complication or new fracture * hip xray: diffuse osteopenia with no significant change since and no definite evidence of acute fracture. cbc @ lowest point wbc 7.0 hgb 7.6* hct 23.5* 231 cbc @ discharge wbc 5.8 hgb 9.0 hct 27.3 plt 375 chem 7 @ discharge 06:32am blood glucose-134* urean-53* creat-6.5*# na-129* k-4.1 cl-92* hco3-26 angap-15 01:03pm blood %hba1c-5.4 avfistulagram: performance of pta of central cephalic arch stenosis with satisfactory post angioplasty result. brief hospital course: ms. is an 80 yo female on enoxaparin bridge for mechanical avr in preparation for colonoscopy presented with right thigh hematoma and hematocrit drop. 1. hematoma: believed to be secondary to overdosed enoxaparin due to renal failure. patient was admitted with a hct of 34 that dropped to 27. concern for a worsening bleed into her right thigh resulted in transfusion of 4 units prbcs total during her stay. on hospital day 6 it stablizied at 29. her right thigh pain was controlled on morphine iv and oxycodone. the pain subsided to a single daily dose of oxycodone for pain. hematocrit should be monitored daily. 2. hypertensive urgency: sbp in the 220s on presentation to ed as the patient had not taken bp meds on admission. she was transferred to the micu for closer monitoring. in the icu, the patient received her home regimen of hydralazine and metoprolol which controlled her blood pressure. there were no more incidents on this home regimen throughout the stay. she should be continued on current regimen of metoprolol and hydralazine. 4. s/p aortic valve replacement: patient has mechanical valve. patient admitted with inr of 1.7 and 1mg of warfarin qday. due to acute bleed all anticoagulation was stopped. anticoagulation with heparin gtt and coumadin was restarted after hematocrit stabilized. she is currently on warfarin 5mg po qday and heparin gtt should be stopped onced inr is between 2.0-3.0. it is 1.4 at the time of discharged today. 5. end stage renal disease: the patient is anuric and has been on hemodialysis 3 times per week for six months. during her stay she was kept on this regimen. 6. diabetes (type ii) the patient has an unclear of diabetes versus hyperglycemia. she has not outpatient therapy for diabetes. she was maintained on an insulin sliding scale requring approximately 6units throughout the day. her hemoglobin a1c is 5.4, and we have put recommendations to stop insulin and start oral therapy forward to the rehabilitation facility. 7. access: patient has picc line and tunnelled line. medications on admission: 1.amiodarone-200 mg tablet-1 tablet(s) by mouth daily- (prescribed by other provider) 2.aspirin-81 mg tablet, delayed release (e.c.)-1 tablet(s) by mouth daily (daily)- (prescribed by other provider) 3.b complex-vitamin c-folic acid -1 mg capsule-1 capsule(s) by mouth once a day- (prescribed by other provider) 4.epoetin alfa-4,000 unit/ml solution-1 solution(s) qmowefr (monday -wednesday-friday)- (prescribed by other provider) 5.esomeprazole magnesium -40 mg capsule, delayed release(e.c.)-1 capsule(s) by mouth daily- (prescribed by other provider) 6.fluticasone-salmeterol-250 mcg-50 mcg/dose disk with device-1 disk(s) inhaled twice a day- (prescribed by other provider) 7.hydralazine-25 mg tablet-1 tablet(s) by mouth every six (6) hours- (prescribed by other provider) 8.levothyroxine-75 mcg tablet-1 tablet(s) by mouth daily (daily)- (prescribed by other provider) 9.metoprolol tartrate-50 mg tablet-1 tablet(s) by mouth twice a day- (prescribed by other provider) 10.simvastatin-20 mg tablet-1 tablet(s) by mouth once a day- (prescribed by other provider) 11.warfarin-1 mg tablet-goal inr 2.5-3.0 tablet(s) by mouth daily (daily) as needed for mech avr please dose based on inr result - goal inr 2.5-3.0 with pt/inr checked daily until off heparin and then mon/wed/fri for continued dosing- (prescribed by other provider) discharge medications: 1. levothyroxine 75 mcg tablet sig: one (1) tablet po daily (daily). 2. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 3. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). 4. hydralazine 25 mg tablet sig: one (1) tablet po q6h (every 6 hours). 5. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 6. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 7. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 8. insulin lispro 100 unit/ml solution sig: one (1) subcutaneous asdir (as directed). 9. oxycodone 5 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed. 10. zolpidem 5 mg tablet sig: one (1) tablet po qhsprn. 11. acetaminophen 325 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed. 12. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day): hold for loose stools. 13. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day): hold for loose stools. 14. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po q8h (every 8 hours) as needed. 15. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection prn (as needed) as needed for line flush. 16. warfarin 5 mg tablet sig: one (1) tablet po once daily at 4 pm. 17. sodium chloride 0.9 % 0.9 % solution sig: one (1) ml injection prn (as needed) as needed for line flush. 18. sodium chloride 0.9 % 0.9 % solution sig: three (3) ml injection prn (as needed) as needed for line flush. 19. morphine 2 mg/ml syringe sig: one (1) injection q2h (every 2 hours) as needed. 20. heparin (porcine) in d5w 25,000 unit/250 ml parenteral solution sig: one (1) intravenous asdir (as directed). 21. heparin, porcine (pf) 10 unit/ml syringe sig: one (1) ml intravenous prn (as needed) as needed for line flush. 22. nexium 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 23. aspirin 81 mg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: hospital discharge diagnosis: primary diagnosis 1. right thigh hematoma 2. end stage kidney disease 3. mechanical aortic valve replacement requiring anticoagulation 4. hyperglycemia secondary diagnosis 1. hypertension 2. history of gastrointestinal bleed necessitating an ostomy 3. hypothyroidism 4. atrial fibrillation discharge condition: stable discharge instructions: you have been admitted with a right thigh hematoma--bleeding into the thigh itself. the bleeding has stopped, but it will take some time before the thigh returns to normal size. you are going to be discharged to a rehab facility while your blood becomes thin enough to pass easily through your mechanical valve. they will also provide rehabilitation services to help the leg, and dialysis for your kidney disease. please take all medications as listed in the discharge instructions as below. of note, you are on a heparin drip along with coumadin. once your blood count is between , the heparin drip can be stopped. under no circumstances should your heparin be changed lovenox because you have developed problems with your kidneys in the past. please return to the emergency department for chest pain, shortness of breath, leg pain or any other medical concerns. followup instructions: please follow up with dr. within a week of discharge from the rehabilitation facility. procedure: venous catheterization, not elsewhere classified hemodialysis angioplasty of other non-coronary vessel(s) arteriography of other specified sites transfusion of packed cells procedure on single vessel diagnoses: hypertensive chronic kidney disease, malignant, with chronic kidney disease stage v or end stage renal disease hyperpotassemia end stage renal disease congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism atrial fibrillation other and unspecified hyperlipidemia heart valve replaced by other means long-term (current) use of anticoagulants kidney dialysis as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure diastolic heart failure, unspecified precipitous drop in hematocrit other complications due to renal dialysis device, implant, and graft hemorrhage, unspecified poisoning by anticoagulants 

Answer: The patient is high likely exposed to