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: hematemesis major surgical or invasive procedure: upper endoscopy history of present illness: ms. is an 86 f with a medical history notable for cholangiocarcinoma and previous upper gi bleed in of . evaluation for the gi bleed revealed gastritis. she woke on with coffe-ground emesis and was admitted to the . on arrival to her initial evaluation was notable for pulse 111, bp 88/67, and hct 34.1. her hct decreased to 25.5 after iv fluids. she received 1 unit of prbc and had an upper endoscopy that revealed a large paraesophageal hernia without evidence of active bleeding. in the icu she received an iv ppi. she remained hemodynamically stable throughout the icu course and had no other active issues. she was transferred to the general medicine . ros: prior to admission she felt well with no fevers, chills, abdominal symptoms, or recent illnesses. she does not have problems with nausea or vomitting with her chemotheray or at other times. other systems reviewed and otherwise negative. past medical history: cholangiocarcinoma: presented with painless jaundice 5/. in she required stent placement out of concern for cholangiocarcinoma. specifically, dr. placed an 8cm by 8mm biliary stent through stricture to the left hepatic duct on . currently under treatment with gemcitabine. oncologist is dr. at . paroxysmal atrial fibrillation hyptertension alzheimer's dementia social history: currently living with her daughter, , after her recent admission for cholangitis/stent replacement. she smoked ppd for approximately 10 years. no longer smokes. she occasionally drinks alcohol but none currently. family history: 70 yo sister with pancreatic cancer. physical exam: physical exam on arrival to the floor: - vital signs: t 97.8, p 71, bp 110/70, 97% on ra. - gen: elderly female sitting up in bed in nad. - heent: sclera anicteric. - chest: normal respirations and breathing comfortably on room air. lungs clear to auscultation bilaterally. - cv: pmi normal size and not displaced. regular rhythm. normal s1, s2. no murmurs or gallops. jvp 7 cm. - abdomen: normal bowel sounds. soft, nontender, nondistended. - extremities: no ankle edema. - skin: no lesions, bruises, rashes. - neuro: alert, oriented x2-3. good fund of knowledge but gets easily confused on details such as dates and names of medications during our conversation. her daughter helps her with the details at most times. cn 2-12 intact. ambulates with a walker. - psych: appearance, behavior, and affect all normal. pertinent results: admission laboratory studies: - 10:35am glucose-152* urea n-31* creat-1.1 sodium-141 potassium-4.1 chloride-96 total co2-35* anion gap-14 alt(sgpt)-34 ast(sgot)-37 ld(ldh)-326* alk phos-177* tot bili-0.5 ctropnt-<0.01 albumin-4.1 - 10:35am wbc-6.3 (neuts-78.0* lymphs-16.3* monos-4.1 eos-0.8 basos-0.8) rbc-3.63* hgb-11.4* hct-34.1* mcv-94 mch-31.4 mchc-33.4 rdw-16.7* plt count-515*# - 10:35am pt-11.8 ptt-25.0 inr(pt)-1.0 repeat cbc: - 08:36pm wbc-7.5 rbc-2.75* hgb-8.6* hct-25.5* mcv-93 mch-31.4 mchc-33.8 rdw-16.3* discharge laboratory studies (after 1 u prbc): - 05:40am blood wbc-7.0 rbc-3.04* hgb-9.5* hct-28.4* mcv-94 mch-31.1 mchc-33.3 rdw-17.3* plt ct-342 brief hospital course: ms. presented with 1 day of coffee-ground emesis with no antecedent nausea, vomiting, stomach pain, or illness. she was hypotensive on arrival and required 1 unit of packed red blood cells. she was admitted to the icu. her bleeding resolved without intervention and an upper endoscopy revealed no etiology of her bleeding. the endoscopy did reveal her known, large, hiatal hernia. presumed etiologies include - tear or unidentified gastritis (given her history of gastritis). she was transferred to the floor. she had no further episodes of bleeding. at discharge she was tolerating a regular diet and having normal bowel movements; she had no abdominal tenderness on physical examination. in an attempt to prevent further episodes she should continue on her ppi, hold her aspirin (indication: stroke primary prevention), and her oncologist will minimize nausea/vomiting with chemotherapy. management of other chronic medical issues outlined below. 1. atrial fibrillation - maintained in sinus rhythm despite missing a few doses of verapamil on arrival due to hypotension; continued on verapamil at discharge 2. hypertension - continued on lasix and verapamil at discharge 3. cholangiocarcinoma - see note above - in addition, we had a goals of care discussion. ms. is unsure about her code status for future hospitalizations and will discuss this with her family and regular medical team before her next admission. full code at discharge. she has an appointed hcp, her daughter (). her family knows she would not like prolonged courses of intensive medical care but is unsure regarding cpr and brief intubation. medications on admission: current medications (verified with daughter): 1. verapamil 80 mg 2. multivitamin 1 tablet daily 3. furosemide 20 mg daily 4. omeprazole 20 mg (occasionally misses 2nd dose) 5. nystatin powder topically--unclear if still taking 6. aspirin 81 mg daily 7. ferrous sulfate 325 mg daily discharge medications: 1. verapamil 80 mg tablet sig: one (1) tablet po twice a day. 2. multivitamin tablet sig: one (1) tablet po once a day. 3. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). 4. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. 5. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po once a day. discharge disposition: home discharge diagnosis: primary: upper gi bleed secondary: cholagniocarcinoma, atrial fibrillation, hypertension, and dementia discharge condition: mental status: confused - sometimes. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). tolerating a regular diet and had normal bowel movements. no abdominal tenderness on physical exam. discharge instructions: dear ms. , you were admitted with blood in your vomit. you required a transfusion and the bleeding resolved on its own. an upper endoscopy did not reveal a source of the bleeding. we are not sure why this happened to you. to try and prevent this in the future, we will continue your acid-supressing medications (omeprazole), hold your aspirin, and we discussed ensuring that you avoid nausea with chemotherapy with your oncologist, dr. . you can continue your other medications as before. please call your doctor or return to the hospital if you note vommiting, blood in your stool, lightheadedness, or any other concerning symptoms. followup instructions: please follow-up with dr. in the next week. she knows you will need to delay your chemotherapy but you should discuss rescheduling this with her. procedure: other endoscopy of small intestine diagnoses: unspecified essential hypertension acute kidney failure, unspecified atrial fibrillation diaphragmatic hernia without mention of obstruction or gangrene alzheimer's disease dementia in conditions classified elsewhere without behavioral disturbance hemorrhage of gastrointestinal tract, unspecified hypovolemia malignant neoplasm of extrahepatic bile ducts 

Answer: The patient is high likely exposed to