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: ace inhibitors attending: chief complaint: coffee ground emesis, fall patient is a 72 -year-old male with pmh of cad s/p des to lad for 90% stenosis on (on asa, plavix), htn, hlid, and alcohol abuse who presented to osh on day prior to admission after falling at home. the fall was mechanical, but in the setting of having consumed one bottle of wine. he reportedly drinks 2 bottles of wine per day at home. patient went to , where he was admitted with a right femoral neck fracture. ct head and neck there showed no hemmorhage or fracture. at , patient had one episode of coffee ground emesis which was positive for blood. gi was consulted there and protonix was started. no further bleeding occured and patient remained hemodynamically stable. the patient wanted to have his hip surgery performed here at and was transferred. he was to be transferred to the inpatient medicine service tonight, however, en route with ems he developed nausea and vomiting of coffee ground emesis, approximately 500 cc. in the ed, initial vs were: 97.6 102 149/100 18 96% 4l - ng tube placed with an additional 5-600 cc of coffee-ground emesis. he later vomited around ngt with frank red blood. his stools are guaiac + and brown. -gi informed, and plan to scope tonight. he is type and crossed, 2 18g iv and 1 16g iv -he is on a protonix gtt post bolus and was started on octreotide as well. -he is tachycardic presumably from withdrawing from alcohol and bleed -vs prior to transfer: hr 97, 20, 93% on 2l?, 155/98 on arrival to the micu, patient's vs. t98.3, hr94, bp170/80, rr16, o2sat:94%. he had another small episode of coffee ground emesis about 100cc and the ng tube continues to suction with black contents. major surgical or invasive procedure: right hip hemiarthroplasty egd history of present illness: patient is a 72 -year-old male with pmh of cad s/p des to lad for 90% stenosis on (on asa, plavix), htn, hlid, and alcohol abuse who presented to osh on day prior to admission after falling at home. the fall was mechanical, but in the setting of having consumed one bottle of wine. he reportedly drinks 2 bottles of wine per day at home. patient went to , where he was admitted with a right femoral neck fracture. ct head and neck there showed no hemmorhage or fracture. at , patient had one episode of coffee ground emesis which was positive for blood. gi was consulted there and protonix was started. no further bleeding occured and patient remained hemodynamically stable. the patient wanted to have his hip surgery performed here at and was transferred. he was to be transferred to the inpatient medicine service tonight, however, en route with ems he developed nausea and vomiting of coffee ground emesis, approximately 500 cc. in the ed, initial vs were: 97.6 102 149/100 18 96% 4l - ng tube placed with an additional 5-600 cc of coffee-ground emesis. he later vomited around ngt with frank red blood. his stools are guaiac + and brown. -gi informed, and plan to scope tonight. he is type and crossed, 2 18g iv and 1 16g iv -he is on a protonix gtt post bolus and was started on octreotide as well. -he is tachycardic presumably from withdrawing from alcohol and bleed -vs prior to transfer: hr 97, 20, 93% on 2l?, 155/98 on arrival to the micu, patient's vs. t98.3, hr94, bp170/80, rr16, o2sat:94%. he had another small episode of coffee ground emesis about 100cc and the ng tube continues to suction with black contents. past medical history: cad s/p des to lad for 90% occlusion htn hlid colon diverticulosis social history: lives with wife, children. drinks ~2 bottles of wine daily for years, no tobacco, no drugs family history: per omr, no family history of premature coronary disease or sudden death. physical exam: admission exam vitals: t98.3, hr94, bp170/80, rr16, o2sat:94% general: alert, oriented, tremulous heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, diastolic murmur heard best at the left anterior axillary line in the 5th itnercostal space lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-distended, bowel sounds present, no organomegaly, no tenderness to palpation, no rebound or guarding gu: foley in place ext: warm, well perfused, no clubbing, cyanosis or edema, brisk capillary refill in the lower extremitied bilaterally neuro: cnii-xii grossly intact, sensation to light touch intact in 2 dermatomes in the lower extremities bilatrally, moves toes to command in both lower extremities discharge exam : vs: 98.5 154/80 (135-172/68-90) 61 (61-84) 18 95ra general: well appearing gentleman, nad, laying comfortably in bed, slow to respond to questions heent: eomi, sclera anicterus cv: rrr s1 s2, no murmurs, rubs, gallops lungs: cta b/l, no rhonchi, crackles, wheezes abdomen: soft, nontender, nondistended, +bs, no hepatomegaly appreciated extremities: no cyanosis, clubbing or edema, 2+ peripheral pulses; r hip dressing, clean/dry/intact. slight tenderness to palpation neuro: cn 2-12 grossly intact, normal muscle strength throughout, except rle which was not tested pain; able to wiggle toes b/l, normal sensation throughout, + tremor pertinent results: admission labs 07:30pm blood wbc-14.5*# rbc-4.76 hgb-13.8* hct-42.0 mcv-88 mch-29.0 mchc-32.8 rdw-14.1 plt ct-198 07:30pm blood neuts-84.3* lymphs-9.6* monos-5.5 eos-0.4 baso-0.2 07:30pm blood pt-12.6* ptt-25.4 inr(pt)-1.2* 07:30pm blood glucose-148* urean-16 creat-1.2 na-142 k-4.2 cl-100 hco3-26 angap-20 07:30pm blood alt-19 ast-25 ck(cpk)-187 alkphos-48 totbili-1.9* 07:30pm blood lipase-26 07:30pm blood ck-mb-2 07:30pm blood ctropnt-<0.01 07:30pm blood albumin-4.3 09:06pm blood hgb-14.3 calchct-43 h. pylori - negative . urine 08:25pm urine color-yellow appear-hazy sp -1.017 08:25pm urine blood-neg nitrite-neg protein-30 glucose-neg ketone-tr bilirub-neg urobiln-neg ph-5.5 leuks-neg 08:25pm urine rbc-5* wbc-3 bacteri-few yeast-none epi-0 12:42am urine casthy-3* . micro urine culture - no growth blood cultures - no growth imaging cxr: findings: single portable view of the chest is compared to previous exam from . the lungs are clear of focal consolidation. please note the left costophrenic angle is excluded from the field of view. cardiomediastinal silhouette is within normal limits for technique. osseous structures are unremarkable. colonic interposition over the liver seen in the right upper quadrant. impression: no definite acute cardiopulmonary process. . echo the left atrium is normal in size. there is mild symmetric left ventricular hypertrophy with normal cavity size and global systolic function (lvef>55%). due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. right ventricular chamber size and free wall motion are normal. there is no aortic valve stenosis. no aortic regurgitation is seen. trivial mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. impression: no outflow tract obstruction or clinically-significant valvular disease seen. normal global biventricular systolic function. . cxr low lung volumes and supine positioning exaggerate heart size and crowd the pulmonary vasculature but there is no pulmonary edema or pneumonia, no pleural effusion or evidence of pneumothorax. severe gaseous distention of the gut would make it difficult to detect pneumoperitoneum in this supine patient. . r knee xray two views right knee: there is no joint effusion. a frontal view is not provided. the oblique and lateral views demonstrate no definite fracture. there are moderate-sized patellofemoral osteophytes and enthesophytes. vascular calcifications are noted. impression: right subcapital hip fracture . r. hip xray two views right knee: there is no joint effusion. a frontal view is not provided. the oblique and lateral views demonstrate no definite fracture. there are moderate-sized patellofemoral osteophytes and enthesophytes. vascular calcifications are noted. impression: right subcapital hip fracture. . r. hip xray (intra-op) findings: there has been placement of a right hemiarthroplasty with a cemented femoral component. there are no signs for hardware-related complications. please refer to procedure note for additional details. . cxr the heart is not enlarged. heart size is at the upper limits of normal. the aorta is calcified and minimally unfolded. no chf, focal infiltrate, or effusion is identified. no pneumothorax or pneumomediastinum is detected. minimal pleural fluid or thickening at the right lung base is unchanged compared with at 1:35 a.m. incidental note is made of the right hepatic colon flexure seen immediately beneath the right hemidiaphragm, unchanged. . discharge labs: 06:45am blood wbc-8.3 rbc-3.03* hgb-8.9* hct-27.4* mcv-90 mch-29.5 mchc-32.6 rdw-14.4 plt ct-263 06:45am blood glucose-113* urean-18 creat-1.0 na-138 k-3.1* cl-102 hco3-27 angap-12 brief hospital course: patient is a 72yo male with pmh of cad s/p des to lad for 90% stenosis on (on asa, plavix), htn, hld, and alcohol abuse who presented to osh on day prior to admission after falling at home found to have r. hip fracture. he developed coffee ground emesis during evaluation and was subsequently found to have tear and is now s/p surgical repair. #gi bleed: patient found to have coffee ground emesis. given history of heavy alcohol use concern for alcoholic gastritis vs. varices from potential cirrhosis. egd from for odynophagia showed no varices. gi was consulted. upper endoscopy showed severe esophagitis, blood in the stomach body, - tear s/p endoclip, severe duodenitis, and erosium in the antrum. patient was initially started on octreotide and protonix drips. after endoscopy, octreotide was discontinued given no varices. he was transitioned to iv ppi the following day. he was also continued on sucralfate. the patient's crits were trended and ultimately stabilized. he had no further bleeding while on the floor. mr. will need follow up outpatient endoscopy. . #hip fracture: patient found to have right femoral neck fracture. he underwent right hip hemiarthroplasty. he was started on lovenox 40 subq daily and will need to continue this for 2 weeks (end date ). patient was evaluated by pt during admission. he will need outpatient follow up with orthopedics. . #alcohol abuse: patient has heavy alcohol use at home, up to 2 bottles of wine daily by report. he denies history of alcoholic hallucinosis or withdrawal seizures. he was briefly on ciwa, but scored only once. the patient was continued on multivitamin, folate, and thiamine. #cad s/p des: patient had des to lad on . admission ecg shows diffuse t-wave flattening. cardiac enzymes negative times one. the patient did not have any chest pain or palpitations during this admission. he was continued on his plavix and asa. the patient's asa was reduced from full dose to 81 while in the micu; he was discharged on asa 325. his metoprolol was initially held, but once he was not longer actively bleeding, his metoprolol was restarted. the patient was continued on his statin. # alcoholic hepatitis: the patient was noted to have elevated tbili, as well as a transaminitis. he was evaluated by liver who thought that this could be early stages of alcoholic hepatitis. the patient's lfts were trending, and he was encouraged to have adequate nutrition. upon discharge, the patient's lfts were trending down. #murmur over mitral valve: echo from showed no valvular pathology, murmur clearly auscultated. repeat tte yesterday showed no valvular pathology. . #psych medications: the patient was continued on his patient is on clonazepam and lexapro. . transitional issues: - the patient was full code on this admission. - the patient will need follow up egd in 8 weeks--> appt has been made for at 9am. - please continue lovenox until . medications on admission: home medications: (not confirmed with patient but taken from clinic visit) plavix 75mg po daily lexapro 10mg po daily benicar 20mg po daily crestor 40mg po qhs omega 3 fatty acids vit d 1000 unit cap asa 325mg po daily clonazepam 1.5mg po qhs (0.5mg tabs) metoprolol succinate 50mg po daily medications on transfer from osh: heparin 5000u sc q12 losartan 50mg po daily clonazepam 1.5mg po qhs simvastatin 40mg po daily plavix 75mg po daily metoprolol succinate 25mg po daily pantoprazole 40mg iv bid dilaudid 1mg im q4h prn ondansetron 4mg iv q6h prn discharge medications: 1. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 2. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 3. escitalopram 10 mg tablet sig: one (1) tablet po daily (daily). 4. benicar 20 mg tablet sig: one (1) tablet po once a day. 5. rosuvastatin 20 mg tablet sig: two (2) tablet po daily (daily). 6. metoprolol succinate 50 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po once a day. 7. aspirin 325 mg tablet sig: one (1) tablet po once a day. 8. clonazepam 0.5 mg tablet sig: three (3) tablet po at bedtime. 9. vitamin d3 1,000 unit capsule sig: one (1) capsule po once a day. 10. omega 3 oral 11. sucralfate 1 gram tablet sig: one (1) tablet po qid (4 times a day). 12. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 13. multivitamin tablet sig: one (1) tablet po daily (daily). 14. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 15. ranitidine hcl 150 mg capsule sig: one (1) capsule po twice a day. 16. lovenox 40 mg/0.4 ml syringe sig: one (1) syringe subcutaneous once a day: end date: . discharge disposition: extended care facility: bay skilled nursing & rehabilitation center - discharge diagnosis: primary diagnosis: right femoral neck fracture - tear duodenitis, esophagitis secondary diagnosis: alcohol abuse discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: dear mr. , it was a pleasure taking care of you while you were hospitalized at . you were transferred here because you needed a hip surgery after falling. while in the emergency department, you were noted to be vomiting blood and you underwent an emergent endoscopy, where the stomach doctors put a down your throat to look into your stomach and intestines; they found an area that was bleeding, which they fixed. both your fall and the bleeding that you had were due to drinking alcohol. it is very important that you stop drinking alcohol. your liver functioning was also affected during this hospitalization; it is now getting better, but you strongly urge you to stop drinking. we made the following changes to your medications: start sucralfate 1 gram by mouth four times daily start enoxaparin 40 mg injected subcutaneously daily (end date ) start thiamine 100 mg by mouth daily start folic acid 1 mg by mouth daily start multivitamin by mouth daily start ranitidine 150 mg by mouth twice daily followup instructions: please follow-up with your primary care doctor within 1 week of leaving the rehab department: digestive disease center when: friday at 10:00 am building: building (/ complex) campus: east best parking: main garage department: endo suites when: friday at 10:00 am procedure: partial hip replacement endoscopic control of gastric or duodenal bleeding diagnoses: coronary atherosclerosis of native coronary artery unspecified essential hypertension depressive disorder, not elsewhere classified percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia old myocardial infarction hypoxemia duodenitis, without mention of hemorrhage esophagitis, unspecified gastroesophageal laceration-hemorrhage syndrome fall from other slipping, tripping, or stumbling leukocytosis, unspecified other and unspecified alcohol dependence, continuous acute alcoholic hepatitis alcohol withdrawal long-term (current) use of aspirin other closed transcervical fracture of neck of femur 

Answer: The patient is high likely exposed to