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: bleeding from mouth/nose major surgical or invasive procedure: nasal packing placement ngt placement transfusion of blood products history of present illness: mr. is a spanish-speaking 74 yom (son is translating in the ) with a h/o cad (s/p stent ), cva, gerd and asthma who presented to the ed from home with 2+ hours of "spitting up" blood. per patient and family, this was not or hemoptysis, but rather blood in the op. he denied emesis, cough, ent pain, abd/chest pain, melena/brbpr and sob. . in the ed, vs were t 99.2, p 79, bp 176/76, rr 14, 99% ra. ng tube was attempted to be placed twice w/o success; thus, ng lavage was not performed. he was noted to have bleeding from his np and the right nares was packed (around 5 pm pm on ). by 8 pm, the packing had been soaked through; the patient was then given affrin and a balloon was put in place to tamponade the bleed. hct was 32.9 on admission with a baseline in low 40's as of (mcv unchanged). given he was not tachycardic or orthostatic, he did not receive an rbc transfusion in the ed. . of note, the patient is on warfarin for stroke/tia (?); ed notes say had a dvt in rle one month ago and has been on coumadin since that time, though has older rxn in omr. his inr was noted to be 14.1 on admission. he was given 10 mg iv vit k; two units of ffp have been ordered but not yet administered. the ed staff also spoke with the cards fellow given the recent stent placement (in right ? le artery for pvd); they advised to keep on asa and plavix currently. . ent saw him in the ed and did a flex scope and standard anterior rhinoscopy. they noted several areas of oozing along the septum bilaterally w/o a clear single, brisk source. gauze soaked in bacitracin was placed in the right nares. left nares was packed with gelfoam and surgicell packing. oral cavity clear. . the ed staff spoke with the gi fellow, who is deferring egd tonight and is recommending iv ppi overnight. low suspicion for ugib. past medical history: tia, on coumadin asthma hyperlipidemia hypertension diabetes gerd h/o prostate cancer cad, s/p mi with lv dysfunction, ef 45-50% pvd s/p cabg x2 in with svg-pda occluded s/p rca stent x 2 (in (?), ); with cypher /p bilateral renal artery stenting followed by redo left renal artery stent for in-stent restenosis in h/o right occipital infarct with residual lest sided visual impairment h/o cataract of left eye macular hole in left eye s/p phacoemulsificatiion, posterior chamber intraocular lens placement, pars plana vitrectomy, membrane peel of left eye social history: -- he lives with his signficant other (). -- he does not smoke or drink. -- he is retired from maintenance and previously worked as a bricklayer in . -- he emmigrated to the us 35 years ago. family history: - not contributory physical exam: general: well appearing; somewhat restless in bed heent: nose packed in ed (did not remove to examine); op clear w/o evidence of bleeding lungs: cta b/l cardio: iii/vi ?sem, loudest at lusb; no m.r.g. abd: soft, ntnd, no suprapubic tenderness extremities: no edema skin: no rashes, no cyanosis neuro: aa, ox3; cn ii - xii in tact pertinent results: 05:15pm blood wbc-14.8*# rbc-4.22* hgb-11.3* hct-32.9* mcv-78* mch-26.8* mchc-34.4 rdw-14.7 plt ct-186 05:15pm blood neuts-87.6* lymphs-8.9* monos-2.9 eos-0.4 baso-0.2 05:15pm blood pt-105.1* ptt-96.9* inr(pt)-14.1* 05:15pm blood glucose-221* urean-34* creat-1.5* na-139 k-4.8 cl-101 hco3-32 angap-11 05:15pm blood alt-27 ast-28 alkphos-141* totbili-0.4 05:02am blood ck-mb-3 ctropnt-<0.01 12:45pm blood ck-mb-3 ctropnt-<0.01 05:02am blood calcium-8.8 phos-2.4* mg-1.9 . ecg: nsr 78, nml axis, first degree avb, no new st changes brief hospital course: assessment/plan: 74 y/o spanish speaking m with h/o pvd s/p stenting of rle in , cva, gerd and asthma who presented to the ed with gross epistaxis and hct drop in setting of elevated inr. . #) epistaxis/bleed: initially unknown source, however ent scoped the patient and visualized bleeding. there were several areas of oozing along the septum bilaterally w/o a clear single, brisk source. gauze soaked in bacitracin was placed in the right nares. left nares was packed with gelfoam and surgicell packing. pt was reversed with vitamin k and ffp, treated with keflex and monitored overnight in the icu. bleeding was felt to be secondary to extremely supratherapeutic inr. patient reported taking his coumadin twice a day which likely led to increased levels. hct decreased from 38 to 29, however it remained stable after packing. he was called out to the floor on the 2nd hospital day and hct remained stable. his coumadin was held and on the day of discharge inr was 1.2. he will continue keflex while packing in place and this will remain in for 5 days. he will follow up with dr. (ent) for packing removal. given recent stent placement he was continued on asa and plavix. . #) arf: bun 34, cr 1.5 on admission; baseline cr 1.0-1.1. bun:cr ratio suggested pre-renal etiology. cr returned to baseline with ivf. . #) leukocytosis: wbc was 14 on admission. patient was afebrile. felt to be stress response given no localized signs of infection. he was treated with keflex prophylactically and wbc normalized on day of discharge. . #) cad/recent stent: the ed staff spoke with the cardiology service given the recent stent placement in rle; they advised to keep on asa and plavix. . #) gerd: initially on protonix given concern for possible gi source of bleed. this was then stopped and patient was discharged on his usual outpatient ranitidine. . #) diabetes: patient is on metformin and nph as outpatient. his metformin was held while in house. he was placed on a insulin ss while inpatient. he will resume his outpatient regimen on discharge. . #) hyperlipidemia: continued statin. . #) asthma: continued albuterol and advair. . #) htn: on amlodipine and lisinopril at home. antihypertensives were initially held given bleeding. these were restarted at discharge. . #) code: full (confirmed with son) . #) communication: son ; pcp . medications on admission: nitroglycerin 0.3 sl prn aspirin 325mg daily albuterol ih 2 puff q6h prn albuterol 4mg tab po q12 amlodipine 5mg po daily albuterol 100mg daily atorvastatin 80mg daily clonidine 0.1 mg po bid advair 100-50 ih lisinopril 20mg po daily singulair 10mg po daily ranitidine 150mg po daily iron 325 po daily fexofenadine 60mg po daily plavix 75 mg daily warfarin 5mg po daily insulin nph 35 units qam loratadine 10mg po daily discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. albuterol 90 mcg/actuation aerosol sig: two (2) puffs inhalation every six (6) hours as needed for shortness of breath or wheezing. 3. amlodipine 5 mg tablet sig: one (1) tablet po once a day. 4. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 5. clonidine 0.1 mg tablet sig: one (1) tablet po bid (2 times a day). 6. fluticasone-salmeterol 100-50 mcg/dose disk with device sig: one (1) puff inhalation (2 times a day). 7. lisinopril 20 mg tablet sig: one (1) tablet po once a day. 8. montelukast 10 mg tablet sig: one (1) tablet po daily (daily). 9. ranitidine hcl 150 mg tablet sig: one (1) tablet po once a day. 10. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po daily (daily). 11. fexofenadine 60 mg tablet sig: one (1) tablet po daily (daily). 12. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 13. insulin nph human recomb 100 unit/ml suspension sig: thirty five (35) units subcutaneous once a day: please resume your home dose of insulin. 14. loratadine 10 mg tablet sig: one (1) tablet po once a day. 15. cephalexin 500 mg capsule sig: one (1) capsule po q8h (every 8 hours) for 4 days. disp:*12 capsule(s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: primary: epistaxis s/p nasal packing elevated inr secondary: coronary artery disease cva gerd asthma hypertension diabetes discharge condition: stable, no further bleeding, inr normalized discharge instructions: you were admitted to the hospital for bleeding from your nose. this was felt to be due to your coumadin level being too high. you should not take your coumadin until your nasal packing is removed and you follow up with dr. . please stop your coumadin. you will need to complete a course of antibiotics to prevent infection at the packing site. you can continue your other medications as prescribed. you should keep your follow up appointments as below. please avoid straining and bending over to prevent recurrent bleeding. please call your doctor if you have recurrent bleeding, chest pain, difficulty breathing, high fevers or other concerning symptoms. followup instructions: provider: study phone: date/time: 10:30 provider: study phone: date/time: 11:00 provider: , : date/time: 1:30 . please follow up with dr. on thursday, at 9am to have your packing removed. his office is located at . ( medical building) on the , suite e. call if you have any questions. . please follow up with dr. in one week. procedure: transfusion of packed cells other irrigation of (naso-)gastric tube transfusion of platelets control of epistaxis by anterior nasal packing control of epistaxis by anterior nasal packing control of epistaxis by anterior nasal packing diagnoses: abnormal coagulation profile anemia, unspecified coronary atherosclerosis of native coronary artery esophageal reflux unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified personal history of malignant neoplasm of prostate aortocoronary bypass status asthma, unspecified type, unspecified percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia old myocardial infarction pain in joint, pelvic region and thigh personal history of venous thrombosis and embolism personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits other states following surgery of eye and adnexa anticoagulants causing adverse effects in therapeutic use epistaxis leukocytosis, unspecified cataract extraction status lens replaced by other means 

Answer: The patient is high likely exposed to