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: lower gi bleed, likely diverticular major surgical or invasive procedure: colonoscopy history of present illness: the patient is an 80 year old female with h/o lgib presumed secondary to diverticulosis, htn, dm, hypothyroidism on no medications x 1 year who presented with sudden onset painless brbpr. she denied abdominal pain, n/v, lh, dizziness, palpitations, cp, sob. no nsaid or other med use. . in the ed, initial vs were: t99 hr135 bp191/90 rr28 100%ra. exam remarkable for bright red blood with clots on rectal exam without melena. hct 29 from prior baseline around 37 5/. . in micu--she received 3u prbcs and 1l ns . unable to do egd due to poor dentition. on she had a colonoscopy which showed severe diverticulosis but no active bleeding; she rec'd add'l 1u prbc on . was tx'ed to floor but had ongoing bleeding, hct was 27-->23 and was tx back to the micu (). she rec'd add'l 2u prbcs and a tagged rbc scan which was negative. general surgery was consulted who recommended a repeat tagged rbc +/- partial colectomy if can target source. she rec'd 1 more unit prbcs and hct trended up to 33.6. past medical history: lgib presumed secondary to diverticulosis htn-not on meds dm2-not on meds hypothyroidism-not on meds x 1 year social history: lives with daughter. formerly employed as secretary at attorney general's office. smoked 1ppd x approx 20 years, quit 15-20 years prior. denies etoh or ivdu. family history: sister with breast ca. no other fh malignancy, bleeding disorder or gi illness. physical exam: on second admission to floor- vitals: t: 98.1 bp: 157/89 p:88 r:18 o2:100 ra, fs 151 general: oriented x 3, diaphoretic, no acute distress, thin heent: sclera anicteric, mm dry, oropharynx clear neck: supple, large goiter lungs: clear to auscultation bilaterally anteriorly, no wheezes, rales, rhonchi cv: tachy. regular, normal s1 with prominent s2, + heave, no murmurs, rubs abdomen: soft, non-tender, non-distended, ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: 06:25am blood wbc-6.8 rbc-3.72* hgb-10.5* hct-31.3* mcv-84 mch-28.2 mchc-33.5 rdw-15.4 plt ct-185 12:54pm blood hct-24.0* 04:20pm blood fibrino-265 02:01am blood fdp-10-40* 06:25am blood glucose-98 urean-17 creat-0.9 na-146* k-3.7 cl-107 hco3-31 angap-12 06:10am blood ld(ldh)-266* 04:35am blood alt-16 ast-19 alkphos-78 totbili-0.4 06:25am blood calcium-8.7 phos-3.9 mg-1.6 06:10am blood hapto-156 04:35am blood tsh-less than 04:35am blood t4-11.6 01:08pm blood lactate-3.0* tte : the left atrium is normal in size. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). there is no ventricular septal defect. the right ventricular cavity is mildly dilated with normal free wall contractility. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. torn mitral chordae are present. an eccentric, posteriorly directed jet of moderate (2+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened.at least moderate tricuspid regurgitation is seen. there is severe pulmonary artery systolic hypertension. there is no pericardial effusion. . ct chest : 1. large heterogeneous multinodular thyroid with substernal extension and compression and deviation of upper esophagus and trachea to the right. longitudinal dimension of the larger left lobe of thyroid measures at least 12 cm, with coarse calcifications inferiorly. cannot exclude thyroid malignancy by ct appearance. however, no local extension or cervical lymphadenopathy. 2. mild distension of fluid filled distal esophagus. esophageal contour poorly visualized due to lack of oral contrast. gej poorly assessed. 3. small curvilinear lucency along left boarder of infrasternal goiter medial to l main pulmonary artery is of unclear etiology; could represent air within tortuous esophagus or air within one of the small mediastinal veins from injection. given this finding is incidental, esophageal perforation is felt less likely. . assessment and plan: 80 year old female with htn, dm, h/o lgib likely diverticular presenting with brbpr. brief hospital course: 80 year old female with htn and dm on no meds, h/o diverticular lgib admitted with brbpr. . #. brbpr: patient presented with painless brbpr and hct 29 from prior baseline mid 30s. was admitted to the icu for emergent colonoscopy. she had blood transfusion (7 units prbcs). she had a colonoscopy that showed severe divertulosis but no active bleeding. was hemodynamically stable and tranferred to the floor but had more brbpr and was transferred back to icu(). a tagged rbc study after this was negative. over last 5 days of admission, hct remained stable, at 30-33. of note, gi does not want any further inpatient or outpatient workup given that bleed was likely diverticular. appointment made for two days from now, with pcp for patient to followup hct. . # thrombocytopenia: platelets were initially low at 100 but increased to 151 over admission. this is likely consumptive from bleeding v. dilutional since recieved 7 u prbcs total. dic labs negative- including fibrinogen and haptoglobin- and patient had not received heparin so hit unlikely. ldh and fdp elevated but hemolysis thought to be unlikely with other normal values and clinical picture (stable hct, hemodynamically stable, resolving platelets.) . #. tachycardia: hr 130s at admission but resolved to 80s by discharge. most likely secondary to bleed. diff dx also includes hyperthyroidism given tsh<0.02 but t4 normal. of note, tte (performed because patient was tachycardic with undocumented murmur on exam) showed some ruptured chordae tendinae; per cardiology no inpatient followup needed. - appointments made for cardiology clinic to follow. . #. dm2: on no medications at home, blood sugars initially high but resolved to 100s over stay. did not sent home with medications; - pcp should followup. . # htn: on no medications at home and hypertensive in ed- continued to be sbp 120s to 170s. started lisinopril 10 mg daily; - patient should followup bp with pcp. . #. h/o hypothyroidism: tsh low but t4 normal. off levothyroxine x 1 year. repeat tests outpatient especially given thyroid mass (see below.) . #. weight loss/mediastinal mass: patient reports 10 lb weight loss over last year and appears cachectic on exam. neck/mediastinal mass seen on cxr likely represents goiter. ct further delineated mass, but differential still goiter v. malignancy. of note, there is mass effect on esophagus and trachea which needs to be worked up soon for possible surgical removal. - appointments made with both pcp and clinic for followup. . patient was discharged home with pt. medications on admission: none. no nsaid use or otc meds discharge medications: 1. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*1* discharge disposition: home with service facility: vna discharge diagnosis: acute blood loss anemia secondary to lower gi bleed, likely diverticular hypertension elevated blood glucose multinodular thyroid discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to the hospital because you were bleeding from your rectum. when you came to the hospital your blood levels were very low and we transfused you with blood. we performed a colonoscopy which showed severe diverticulosis (which are small areas of outpouching in your colon) but no active bleeding . you re-bled one time here in the hospital. we performed a test called a tagged rbc test but this did not show the source of your bleeding. you have not bled again here in the hospital and your blood levels (hematocrit) have been normal. we want you to see a health care provider on to have your hematocrit checked just to make sure that you are not bleeding any more. . also while you were here in the hospital, we noticed that you have a very large thyroid. we performed a ct scan and this confirmed that the mass in your neck is your thyroid. you should followup with your primary care doctor and an endocrinologist (appointment below) to find out why this mass in so large and make sure that it is not dangerous. the ct did show that it is pressing on your esophagus (tube for eating) and trachea (tube for breathging) so it is important to look for signs of trouble breathing and trouble eating and see your doctor or come to the emergency room if that happens. . finally, while you were here we added one new medication for you- lisinopril. you should take 10 mg daily. this is an important medication for high blood pressure. . while you were in the hospital, your blood glucose (sugar) levels have been high. you should followup with your primary care doctor to find out whether you should be treated for diabetes. . followup instructions: with: np location: community health center address: , , phone: appointment: friday 9:00am *** please get hct checked. with: np location: community health center address: , , phone: appointment: wednesday 12:45pm department: cardiac services when: wednesday at 1:20 pm with: , m.d. building: campus: east best parking: garage department: div of gi and endocrine when: tuesday at 10:00 am with: , md building: ra (/ complex) campus: east best parking: main garage md procedure: colonoscopy diagnoses: thrombocytopenia, unspecified mitral valve disorders unspecified essential hypertension acute posthemorrhagic anemia other pulmonary insufficiency, not elsewhere classified loss of weight cachexia other diseases of lung, not elsewhere classified hypovolemia diverticulosis of colon with hemorrhage nontoxic multinodular goiter anal and rectal polyp rupture of chordae tendineae unspecified gingival and periodontal disease 

Answer: The patient is high likely exposed to