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: penicillins / heparin agents / argatroban / lepirudin attending: chief complaint: r arm numbness/weakness major surgical or invasive procedure: upper endoscopy colonoscopy with polyp removal history of present illness: the pt is a 83 y/o rhf with history of multiple tia's and bilateral cea's mos most recent 2 weeks ago for a left cea after "tia's". she comes in today as an osh transfer for two episodes concerning for tia. she states that yesterday she had a sudden onset inability to get her words out. she states that this lasted hours, was not all words, and had no slurred speech, no inability to understand speech and she knew which words she wanted to say. this resolved and then today had another event where she was suddenly unable to use her right hand. she states she was trying to use a fork for dinner and was unable to do so. this lasted about 3 hours and then resolved. during this time those around her stated that she had a left sided droop and possibly slurred speech. at this point she feels back to baseline. she is unable to give me any useful information regarding her previous "tia's". on ros she denies current ha, language difficulty, vertigo, cp, sob, fever or chills, weakness or chances to sensation. she does however support pain in her low back and hips with walking and uses support for ambulation. past medical history: 1. htn 2. asthma 3. emphysema 4. hx of gi bleed 5. gerd 6. right subclavian stenosis 7. hypothyroid 8. anemia social history: former smoker. drinks wine daily family history: n/c physical exam: physical exam on admission: vitals: t: 98 p:56 r: 16 bp:178/78 sao2:99% general: awake, cooperative, nad. heent: nc/at, no scleral icterus noted, mmm neck: left side post surgical scar clean and intact. no nuchal rigidity pulmonary: lungs cta bilaterally cardiac: rrr, nl. s1s2, no m/r/g appreciated abdomen: soft. extremities: 1+ edema. skin: no rashes or lesions noted. neurologic: -mental status: alert, oriented x 3. unable to provide details to history. able to name dow backward without difficulty. language is fluent with intact repetition and comprehension. there were no paraphasic errors. pt. was able to name both high and low frequency objects. speech was not dysarthric. able to follow both midline and appendicular commands. pt. was able to register 3 objects and recall at 5 minutes with prompts. there was no evidence of apraxia or neglect. -cranial nerves: i: olfaction not tested. ii: perrl 2 to 1mm. vff to confrontation. iii, iv, vi: eomi without nystagmus. normal saccades. v: facial sensation intact to light touch. vii: right side slight facial droop. viii: hearing not intact to finger-rub bilaterally. ix, x: palate elevates symmetrically. : 5/5 strength in trapezii and scm bilaterally. xii: tongue protrudes in midline. -motor: normal bulk, tone throughout. right side pronator drift delt bic tri wre ffl fe ip quad ham ta edb l 5 5 5 5 5 5 5 5 5 5 5 5 5 r 5 5 5 5 5 5 5 5 5 5 5 5 5 -sensory: decreased vibratory sensation at the feet. no extinction to dss. -dtrs: tri pat ach l 2 2 2 2 0 r 2 2 2 2 0 plantar response was extensor on the left mute on the right. -coordination: no rebounding. no dysmetria on fnf bilaterally. -gait: deferred. pertinent results: labs on admission: 08:21pm pt-12.9 ptt-23.9 inr(pt)-1.1 08:21pm plt count-174# 08:21pm neuts-67.1 lymphs-21.2 monos-7.6 eos-3.6 basos-0.5 08:21pm wbc-5.2 rbc-2.86* hgb-10.0* hct-29.3* mcv-103* mch-35.1* mchc-34.2 rdw-13.0 08:21pm estgfr-using this 08:21pm glucose-103* urea n-30* creat-1.6* sodium-139 potassium-4.2 chloride-103 total co2-26 anion gap-14 08:30pm urine mucous-rare 08:30pm urine hyaline-3* 08:30pm urine rbc-1 wbc-46* bacteria-none yeast-none epi-3 trans epi-1 08:30pm urine blood-neg nitrite-neg protein-30 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.0 leuk-lg 08:30pm urine gr hold-hold 08:30pm urine color-straw appear-hazy sp -1.010 08:30pm urine hours-random imaging: ct-a impression: 1. small low attenuation in the left caudate head consistent with an infarct of indeterminate age, likely chronic. 2. small area of low density in the left subinsular white matter, infarct of indeterminate age. 3. no evidence of intracranial hemorrhage. 4. status post left carotid endarterectomy with soft tissue changes and without evidence of a flow-limiting stenosis in the major neck vessels. 5. thrombus in the right proximal subclavian artery. 6. calcifications of the vertebral artery origin, limit evaluation for stenosis. mri-head impression: two small foci of bright diffusion signal abnormalities in the left frontal cortex and left centrum semiovale associated with flair signal changes likely to suggest recent infarcts without convincing adc abnormality. old lacunar infarct in the left head of caudate nucleus. . . eeg impression: this is an abnormal video eeg despite the normal posterior dominant rhythm during the waking state due to the presence of bursts of generalized delta frequency slowing which represents deep midline and subcortical dysfunction. there were no epileptiform discharges or electrographic seizures seen . . echo impression: suboptimal image quality. no obvious cardiac source of embolism in a technically limited study. normal global left ventricular systolic function. technically suboptimal to exclude focal wall motion abnormality. right ventricle not well-visualized. borderline pulmonary hypertension. . . mr head w/o contrast impression: acute watershed infarction involving the left cerebral hemisphere, new since the prior mri of the brain dated , also seen on the prior ct perfusion from . no hemorrhagic transformation is seen. . ct- head impression: evolving left hemispheric watershed infarcts, with no evidence of hemorrhagic conversion. no new acute process is seen. . kub impression: 1. no obstruction or free air. 2. bibasilar atelectasis and pleural effusions. 3. gallstones. . . labs at discharge: brief hospital course: neuro: stroke 83 yo rhw with h/o l cea presented with transient episodes of r hand and arm numbness and speech difficulties. she was initially transferred to the service from center in nh. she had a transient episode of right hand numbness that spread over the right arm and face over seconds to minutes, followed by difficulty using the right hand, disorientation and difficulties speaking. this occured on and again on . neurology was consulted on . neuro exam was significant for right pronator drift and slowness with finger tapping. cta showed bilateral carotids had no significant stenosis. the patient had been started on heparin drip empirically by service. at that concern, neuro team was concerned for hyper- or reperfusion syndrome s/p l cea. it was therefore recommended to keep her blood pressure well controlled (sbp<160) and stop the heparin drip given risk of edema and hemorrhage. eeg was performed to rule out seizure. on overnight, the patient's neuro exam worsened. on evening rounds, she had some slowness in right hand fast finger movements. at 2am, her right arm was flaccid and could not lift it antigravity. neurology nightfloat saw the patient, however at that point it was still unclear whether this episode was due to developing stroke or seizure secondary to hyperperfusion syndrome. the patient's blood pressure was being kept controlled between sbp 100-120 for concern of hyperperfusion syndrome. at 4am, patient was r hemiplegic and aphasic. ct with perfusion done at that time showed ischemia in the l anterior and posterior watershed borderzones. cta showed small plaque in the proximal l common carotid artery. there was no hemorrhage. the patient was transferred to the neuro icu. she was started on heparin drip again for concern of l cca plaque. she was immediately bolused with 2l ivf and then started on neosynephrine to keep map >90-100. she improved with these interventions. her language improved significantly, her right leg was antigravity, though her right arm remained densely plegic. mri showed watershed infarct in the l mca-pca borderzone and internal borderzone superiorly. her neuro exam continued to improve over the next 24 hours. both expressive and receptive language was intact, rle strength was nearly full, and she was able to shrug her rue proximally. she was transferred to the neuro step down unit on . she was continued on heparin drip, with plan to transition to coumadin, but this plan was aborted due to falling hematocrit on . the pathophysiology of the stroke remains unclear. the most likely cause is a mechanical event at the l carotid post-operatively, that transiently blocked the vessel and made the brain suspectible to watershed stroke. repeat ct of the head did not show hemorrhagic conversion and the patient was started on heparin, however transient thrombocytopenia and dropping hct (likely from gi bleed), led to discontinuation of anticoagulation. the patient also had a rue ultrasound that did not show any dvt. over the next days, her clinical motor exam improved daily and her strength in her r upper extremity increased significantly. she was seen by pt who recommended inpatient rehabilitation. heme: the patient's hct at admission was 29. it declined gradually to 25 and then to 23.5 on . she received 1 u prbcs on . hct repeated after transfusion was unchanged, and hct continued to drop over the next 12 hours. ct abdomen and pelvisd was negative. medicine and gi were consulted. hemolysis labs were negative. given the thrombocytopenia, there was a concern for hit. heparin was transitioned to argotroban. however, she developed a rash and this medication was stopped. she was also briefly started on lepirudin, but another rash led to discontinuing these medications as well. repeat falling hct and concern for gi bleed led to discontinuation of all anticoagulation other than aspirin. hit antibodies were positive, however the optical density of this test was low and suggestive of a false positive result. currently, we do not feel this patinet has hit. at the time of discharge, the serotonin release assay results are pending. gi: rectal guiaic was positive without blood, however ng lavage was negative. patient was started on protonix drip empirically which was transitioned to iv push . she then underwent upper and lower endoscopy which revealed "a few small angioectasias with stigmata of recent bleeding seen in the second part of the duodenum. a gold probe was applied for hemostasis successfully." "a single sessile 1.8 cm polyp of benign appearance was found in the transverse colon and this was resected. there was melena found in the ascending colon during this colonoscopy. after colonoscopy, she remained on aspirin (despite recommendations from gi post-procedure), although she was not started on other anticoagulants. on the night after the procedure, she developed abdominal pain (worse in the rlq) that was concerning for possible post-procedure complications. kub did not show free air and the pain decreased over the next 2 days without interventions. her diet was advanced without complication prior to her discharge. her hct remained stable in the low-mid 20s over last 2 days of this admission. gi was reconsulted but did not recommend other acute interventions at this time. she will be followed by gi services as an outpatient in weeks at which time further investigation (repeat colonoscopy or capsule endoscopy) might be undertaken. ckd: patient had baseline cr 1.4-1.6 which was stable. medications on admission: asa 325 plavix levothyroixine 25mcg daily rosuvastatin 20mg daily doxazosin 8mg daily synthroid 25mcg clonidine 0.1 po tid colace percocet 5/125 1po q6 lasix 40mg daily potassium b12 senna discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. rosuvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 4. doxazosin 4 mg tablet sig: two (2) tablet po hs (at bedtime). 5. levothyroxine 25 mcg tablet sig: one (1) tablet po daily (daily). 6. polyvinyl alcohol-povidone 1.4-0.6 % dropperette sig: drops ophthalmic prn (as needed) as needed for dry eyes/ blurriness. 7. acetaminophen 325 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for headache. 8. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 9. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 10. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 11. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po twice a day. 12. potassium chloride 10 meq tablet extended release sig: one (1) tablet extended release po once a day. discharge disposition: extended care facility: center - , nh discharge diagnosis: primary l hemispheric stroke gi bleeding discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). neurologic exam: residual right arm weakness, with distal weakness predominant ( fe, we) discharge instructions: you were admitted to the medical center for numbness and weakness in your arm. upon further investigation and imaging studies it became clear that you had suffered a stroke. this was likely a complication from a previous surgery -endarterectomy- on your left carotid. your weakness improved during your stay and we believe you will benefit from rehabilitation. your hospitalization was complicated by an intestinal bleed. because of this, you underwent an endoscopy and a colonoscopy to investigate the source of bleeding. you had a polyp removed from you colon and small bleeding vessel was intervened on in your stomach. after this you had some abdominal pain that appeared to resolve without intervention. however, given your ongoing bleeding, you were given blood products. we also held blood thinning agents other than aspirin given your ongoing bleeding. we believe your bleeding then slowed down and you were restarted on blood thining agents. during your hospitalization, some of your medications changed, you should note the following: start: - pantoprazole po bid - artificial tears stop: -plavix -clonidine followup instructions: department: div. of gastroenterology when: wednesday at 1 pm with: , md building: ra (/ complex) campus: east best parking: main garage . provider: , md (neurologist) phone: date/time: at 2:00 pm department: div. of gastroenterology when: wednesday at 1 pm with: , md building: ra (/ complex) campus: east best parking: main garage . provider: , md (neurologist) phone: date/time: at 2:00 pm md, procedure: endoscopic control of gastric or duodenal bleeding endoscopic polypectomy of large intestine diagnoses: thrombocytopenia, unspecified esophageal reflux pure hypercholesterolemia congestive heart failure, unspecified unspecified acquired hypothyroidism hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation chronic kidney disease, unspecified other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation dermatitis due to drugs and medicines taken internally chronic obstructive asthma, unspecified anticoagulants causing adverse effects in therapeutic use benign neoplasm of colon cerebral artery occlusion, unspecified with cerebral infarction hemiplegia, unspecified, affecting unspecified side iatrogenic cerebrovascular infarction or hemorrhage angiodysplasia of stomach and duodenum with hemorrhage long-term (current) use of aspirin other acute postoperative pain 

Answer: The patient is high likely exposed to