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: service: history of present illness: the patient is an 84-year-old greek man who presented to the emergency room with an episode of large volume coffee ground emesis immediately following his dinner. he brought a sample of the emesis which was hemoccult positive. the patient also mentioned that he had he had no emesis once he got to the emergency room and he states this never happened to him before. he does occasionally take pepcid but not chronically. he has no history of liver disease or alcoholism he does have a history of breast cancer which was resected ten years ago and without recurrence. the patient also noted decrease in feeling well for the last one to two weeks. no change in his stool to a darker color over the past few weeks. the son did state that his father appeared to have lost some weight. the patient denied any dizziness but had noted some fatigue. he had no chest pain, epigastric or abdominal pain. no nausea, short of breath, no fever or chills. he did have a upper respiratory infection three weeks ago. no other symptoms. past medical history: 1. coronary artery disease, status post percutaneous transluminal coronary angioplasty greater than 10 years ago. 2. type ii diabetes mellitus. 3. breast cancer, status post surgery ten years ago on the right. allergies: no known drug allergies. medications: 1. enteric coated aspirin q day. 2. accupril 20 mg q day. 3. amaril 1 mg twice a day. social history: the patient is a retired shoemaker, he drinks occasional wine. he lives with his son in (the sons name is ). quit smoking 30 years ago. he has an active lifestyle. family history: no history of cancer. physical examination: the patient was afebrile at 98.3 degrees, heart rate of 84, blood pressure of 114/43, respiratory rate of 18, oxygen saturation of 96% on room air. on general exam he was alert and oriented but pale in no apparent distress. head, eyes, ears, nose and throat exam showed normocephalic, atraumatic head with pupils being equal, round and reactive. his extraocular movements intact. his oropharynx was dry. neck was supple with no thyromegaly and no lymphadenopathy, no jugular venous distention. his heart was regular rate and rhythm with a 1/6 systolic diastolic murmur at the right upper sternal border and normal s1 and s2. his lungs were clear to auscultation bilateral. his back showed no spinal tenderness and no cvat. his abdomen was nondistended, nontender with hyperactive bowel sounds. his liver span was about 8 cm not palpable below the costal margin. he had no splenomegaly or tenderness, no caput medusa. per the emergency room he was guaiac positive with brown stool. his extremities showed no cyanosis, clubbing or edema. 2+ radials and 2+ dorsalis pedis pulses bilateral. neurologic exam: his cranial nerves 2 through 12 were intact. his motor and sensory examination was grossly intact. his deep tendon reflexes were 2+ and symmetrical. skin showed no erythema, pale mucosa, no spider angiomata were appreciated. laboratory: the patient's white blood count was 9.4 with a hematocrit of 22.1 (over baseline of 36 to 38 in ) and platelets of 357. sodium was 133, potassium 4.7, chloride 99, bicarbonate 20, bun 50 and creatinine 1.2. electrocardiogram showed normal sinus rhythm at 88 with normal axis,normal intervals and t-wave inversion in avr as well as q's in v4 through v6, tall r's in v2. hospital course: the patient was admitted to the micu initially for workup of an upper gastrointestinal bleed. he was transfused a total of three units of packed red blood cells with good results. he had no further episodes of hematemesis and his stool was brown throughout the hospitalization. given the low hematocrit and the patient's history of coronary artery disease he was ruled out for myocardial infarction with cks of 41, 27 and 30 and troponin's less than .3 each time. on the patient underwent a esophagogastroduodenoscopy which showed a single crater of 3 cm ulcer in the stomach body (lesser curvature) with thickened edematous edges and stigmata of recent bleeding although no blood was seen in the stomach or duodenum. cold forceps biopsies were taken both for histology and for h. pylori. otherwise the patient's esophagogastroduodenoscopy was normal to the second part of the duodenum. the patient's non-steroidal anti-inflammatory drugs were stopped and these were not restarted. he was started on twice a day protonix. the patient did well in the intensive care unit and was sent out to the general medical floor in good condition on . he was hemodynamically stable, his hematocrit was stable in the 33 range. the patient did well but on the night of noted acute sudden onset of pain in his right first metatarsal pharyngeal joint felt to be most consistent with gout. rheumatology consult was called who agreed this most likely represented an episode of gout. given that the patient had no history of prior gout they did not feel that long-term treatment with allopurinol was warranted at this time. given the fact that the patient could not be started on non-steroidal anti-inflammatory drugs or systemic steroids and that colchicine with its gastrointestinal toxicity should also be avoided at this time the rheumatology service injected the metatarsal phalangeal joint with 40 mg of depo medrol with good effect. the patient's pain actually improved overnight. he was also given ultram and tylenol for pain and he was discharged with prescriptions for these medications. the physical therapy service walked with the patient and did not feel the patient needed any further intervention and he was able to walk well. for follow-up for the gastrointestinal issues the patient was scheduled for gastrointestinal follow-up with the gastrointestinal service on and the patient was discharged to home in good condition on with the biopsy result and h. pylori results still pending. following discharge the h. pylori antibody titer came back as negative. later that day, the gastrointestinal service notified the primary team that biopsy of the stomach ulcer showed poorly differentiated adenocarcinoma. the patient has already had a scheduled follow-up with gastrointestinal on which is one week after discharge. the patient's pcp . salamis () was contact with this diagnosis and he will contact the patient and set up him up with outpatient oncology follow-up likely at and decisions for further care can be made at that time. discharge condition: good. discharge status: full code. medications on discharge: 1. protonix 40 mg twice a day. 2. accupril 20 mg q day. 3. amaril 1 mg twice a day. 4. ultram 50 mg p.o. q 4 to 6 hours p.r.n. for pain. discharge diagnosis: 1. upper gastrointestinal bleed secondary to stomach ulcer from poorly differentiated gastric adenocarcinoma. 2. see past medical history. , md dictated by: medquist36 d: 15:34 t: 15:37 job#: procedure: injection of steroid esophagogastroduodenoscopy [egd] with closed biopsy injection of therapeutic substance into joint or ligament diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery personal history of malignant neoplasm of breast percutaneous transluminal coronary angioplasty status chronic or unspecified gastric ulcer with hemorrhage, without mention of obstruction atrophic gastritis, without mention of hemorrhage malignant neoplasm of body of stomach 

Answer: The patient is high likely exposed to