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: lisinopril / metformin attending: chief complaint: brbpr major surgical or invasive procedure: none history of present illness: f, htn, dm2, breast ca., hypercholesterolemia and history of lgib (diverticuli and internal hemmorhoids) presenting with bright red blood per rectum. pt. reports brbpr at baseline (spotting 1-2 times a day). last night, passed increased amount of blood with stool that took a bit longer than normal to stop, in the morning she had some brbpr without stool so she decided to come. she has had some gassy abdominal pain and chronic baseline rectal pain from rectal prolapse, but been otherwise asymptomatic. she denies lightheadedness, palpitations, chest pain, shortness of breath, fevers, chills, melena, diarrhea, constipation. . on ros: pt. only reports some l leg pain over the last month or so. she denies any weakness, and ambulates, but she states that at times the pain migrates to her left knee and limits her mobility. . in ed, she received one l ns and had a hct of 34, which is down 3 points from her latest in , though her chronic baseline over the last two years seems to bump between 32 and 37. past medical history: - noninsulin-dependent diabetes, followed by the diabetes center; hgba1c 7.0 () - hypertension. - hypercholesterolemia - total chol 142, hdl 63,ldl 45, tg 169 - anemia: - lower gi bleed - 2nd to diverticulosis seen on endoscpy in (last in system). - breast cancer - s/p r lumpectomy, recurrence with recurrence in l breast, free excision in , considering local therapy with dr. currently - hemorrhoids - s/p banding, continued internal hemmorhoids - hysterectomy - restrictive lung disease - pfts (): normal fev1, decreased fvc, with fev1/fvc 135% predicted - anginal symptoms - chest tightness during stress mibi () however nuclear study showed normal perfusion; lvef in echo >55% . social history: lives at on her own. cooks her own meals, administers her own meds. denies current alcohol/tobacco use. distant tobaco history of a few years of cigs/wk. history family history: positive for coronary artery disease. no history of colon cancer. physical exam: vitals: t 98.1 bp 102/68 p81 rr16 sat99% ra fsbg 131 gen: well appearing, nad heent: anicteric, perrl, eomi no egn, op clear, no lesions; mmm neck: no pulm: ctab, no wheezes cv: rrr, nls1s2, no mrgs abdm: soft, ntnd, increased bs back: r cva tenderness extrem: sl. cool, no tenting, 2+ pulses, no c/c/e, 2+ dp pulses bilaterally skin: scars in r axilla, l breast from prior surgery neuro: cnii-xii intact, nl strength, sensation b pertinent results: 04:09pm glucose-234* 04:09pm hgb-12.2 calchct-37 03:58pm glucose-248* urea n-28* creat-1.3* sodium-138 potassium-4.0 chloride-101 total co2-27 anion gap-14 03:58pm estgfr-using this 03:58pm wbc-6.4 rbc-3.99* hgb-12.1 hct-34.3* mcv-86 mch-30.2 mchc-35.1* rdw-14.6 03:58pm neuts-64.9 lymphs-25.5 monos-6.0 eos-2.7 basos-0.9 03:58pm plt count-238 03:58pm pt-11.1 ptt-21.1* inr(pt)-0.9 12:30am blood hct-30.2* 05:45am blood wbc-5.1 rbc-3.15* hgb-9.6* hct-26.9* mcv-85 mch-30.5 mchc-35.7* rdw-14.9 plt ct-200 10:45am blood hct-29.3* hct on discharge 33.0 last colonoscope : diverticulosis throughout last egd : duodenitis, otherwise wnl. embo non neuro 3:14 am reason: mesenteric angiogram with possible atheroembolization contrast: visapaque medical condition: year old woman with h/o hemmorrhoids, diverticulosis with lower gi bleed, tagged scan shows bleeding at distal left colon reason for this examination: mesenteric angiogram with possible atheroembolization indication: patient with history of hemorrhoids and diverticulosis with lower gi hemorrhage. tagged red blood cell scan shows bleeding at the distal left colon. please perform arteriogram and possible embolization. radiologists: dr. and dr. performed the procedure. dr. , the attending radiologist, was present and supervising throughout. procedure and findings: informed consent was obtained. a preprocedure timeout was performed. the patient was placed supine on the angiography table, and the right groin was prepped and draped in sterile fashion. 5 cc of 1% lidocaine was used for local anesthesia. by palpation, a 19-gauge seldinger needle was advanced into the right common femoral artery directly over the femoral head. wire was advanced into the abdominal aorta and the puncture needle was exchanged for a 5-french sheath. a 4-french sos omni selective catheter was utilized to access the orifice of the superior mesenteric artery. a superior mesenteric arteriogram was performed demonstrating the sma and its branches to be widely patent without evidence of extravasation. attempts to cannulate the orifice of the with the sos selective catheter were unsuccessful. thus, the omni selective catheter was exchanged for an omniflush catheter, and an aortogram was performed. the aortogram demonstrated patent bilateral renal arteries, an accessory renal artery on the left, the inferior mesenteric artery and lumbar arteries. using this arteriogram as a guide, the orifice of the inferior mesenteric artery was then cannulated with a 5-french mickaelson catheter. the arteriogram was performed in frontal and oblique projections, demonstrating a focus of active arterial extravasation at the junction of the descending and sigmoid colon. a tracker microcatheter was advanced into the inferior mesenteric artery, selctively into a distal branch of the left colic artery. contrast injection at this locale confirmed extravasation from this branch. based on the diagnostic findings, it was decided that the patient would benefit from and was a good candidate for embolization. two 1 cm x 2 mm coils were deployed at this level. subsequent superselective arteriogram from the demonstrated occlusion of the arterial branch responsible for the bleeding. the catheters were removed and the angiographic sheath was pulled. manual compression was applied to the right groin until complete hemostasis was achieved. the patient tolerated the procedure well and there were no immediate complications. moderate sedation was provided by administering divided doses of versed and fentanyl throughout the total intraservice time of 2 hours, during which the patient's hemodynamic parameters were continuously monitored. a total both of 25 mcg of fentanyl and 0.5 mg of versed were administered. approximately 180 cc of visipaque contrast was administered throughout the procedure. impression: 1. superselective arteriogram from the demonstrated a focus of active arterial extravasation near the junction of the descending and sigmoid colon. 2. coil embolization of a left colic of the , with a good angiographic result. brief hospital course: # gi bleed on the floor she was initially hemodynamically stable with stable hematocrits. she had a colonoscopy which showed diverticulosis of the sigmoid colon, descending colon, transverse colon and ascending colon and blood distal to the distal transverse colon. egd showed gastritis, duodenal ulceration and a clot in the fundus. she then returned to the floor and several hours later started having cupfuls of brbpr. she remained hemodynamically stable. she had a central line placed and was sent to tagged rbc scan. per report, she had some bleeding in the distal colon. gi bleeding showed findings consistent with a lower gi bleed. the origin was placed within the descending/sigmoid colon junction. she had selective angiogram by ir with coil emblization of a branch of . she received 5 total units during this time with stabilization of hct. on discharge, hct was 33.0 and stable > 48h. she was placed on ppi on discharge with need for colonoscopy as outpt 1 month after discharge. . * dm: sugars slightly elevated - held glyburide in house and placed on sliding scale. sugars well controlled here. . * cri: baseline appears to be 1.1-1.3 and pt within baseline throughout stay . * chest pain: pt had transient l sided chest pain at 7:30 am. resolved w/in 5 min. no assoc dyspnea, nausea, diaphoresis. -ekg obtained: primary avb (old), t wave flattening v1 (old), v2 (new), v6 (new); change in axis (? lead placement). ces were negative . * rectal prolapse/hemmorhoids: anusol prn, bowel regimen to keep stools soft. . * hypecholesterolemia: continued pravachol. . * htn: held cartia and hctz, but restarted when hct stable we lowered your cardizem xl dose to 120mg per day, which may have to be increased by your pcp. medications on admission: glyburide 5mg hctz 25mg qd ranitidine 150mg dilt. xl 300mg qd feso4 325mg qd colace 100mg pravachol 10mg qhs lantus 12u qam novolog pen 2u qmeal discharge medications: 1. pravastatin 20 mg tablet sig: one (1) tablet po hs (at bedtime). tablet(s) 2. centrum silver tablet sig: one (1) tablet po once a day. 3. hydrochlorothiazide 25 mg tablet sig: one (1) tablet po daily (daily). 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 5. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day). disp:*90 tablet(s)* refills:*2* 6. pramoxine-mineral oil-zinc 1-12.5 % ointment sig: one (1) appl rectal (2 times a day) as needed for rectal pain. disp:*1 qs* refills:*2* 7. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. disp:*60 tablet, delayed release (e.c.)(s)* refills:*0* 8. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). disp:*60 tablet, delayed release (e.c.)(s)* refills:*1* 9. glyburide 5 mg tablet sig: one (1) tablet po twice a day. 10. insulin glargine 100 unit/ml solution sig: fourteen (14) units subcutaneous qam. 11. novolog flexpen 100 unit/ml insulin pen sig: two (2) units subcutaneous qac. 12. diltiazem hcl 120 mg capsule, sustained release sig: one (1) capsule, sustained release po daily (daily). disp:*30 capsule, sustained release(s)* refills:*0* discharge disposition: home discharge diagnosis: gi bleed blood loss anemia gastritis diverticulosis _________________ diabetes mellitus discharge condition: good, ambulating without assistance, tolerating pos, no fresh blood per rectum, satting <95% on room air discharge instructions: please seek medical attention should you develop further gi bleeding, especially bright red blood, or should you continue to hav dark tarry stools. please also seek medical attention should you develop lightheadness, dizziness, chest pain, shortness of breath, or any other concernign symptoms such as fever, nausea, abdominal pain or decreased urine output. please take all medications exactly as prescribed. we have started you on protonix, which you should take twice a day for at least a month. in addition, you should take stool softeners colace and senna twice a day to keep your stools soft. you may also take other over the counter products such as metamucil or prune juice to keep your stools soft. you can also hold your iron pills for now and check with your pcp with regards to when to restart them. we have also lowered your cardizem xl dose to 120mg per day. you may need to have this increased by your pcp on follow up. follow up as below. followup instructions: you should follow up with your pcp in the next week. his number is . you should have your hematocrit checked at this visit. you have been discharged with a hematocrit of ~31. he should also measure your blood pressure as we have decreased your cardizem dose you should also follow up with the gi service in 1 month (. you need to have a colonoscopy scheduled for 1 month from now. you can have that scheduled through your pcp or through the gi group. you also have the following appointments which you should attend. provider: phone: date/time: 1:30 provider: , md phone: date/time: 2:40 procedure: venous catheterization, not elsewhere classified colonoscopy endoscopic control of gastric or duodenal bleeding arteriography of other intra-abdominal arteries other endovascular procedures on other vessels transfusion of packed cells diagnoses: end stage renal disease pure hypercholesterolemia acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified chronic airway obstruction, not elsewhere classified personal history of malignant neoplasm of breast hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease unspecified gastritis and gastroduodenitis, with hemorrhage diverticulosis of colon with hemorrhage internal hemorrhoids without mention of complication 

Answer: The patient is high likely exposed to