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: codeine / sulfa (sulfonamide antibiotics) / iodine attending: chief complaint: ugib major surgical or invasive procedure: egd history of present illness: 54-year-old female with past medical history of ugib secondary duodenal ulcer, on pantoprazole no presents with dark red vomit and dark red bowel movement starting today. . the patient was in her usual state of health until the day of admission. at that time the patient had emesis x1 which was dark red in appearance. she also noted a dark red bowel movement. a few hours later she became lightheaded. this reminded her of her prior duodenal bleed so she presented ew for further evaluation. the patient denies chest pain, palpitations, diarrhea, constipation or other symptoms. she notes mild epigastric discomfort. she has not taken her pantoprazole for "some time". she denies aspirin or nsaid use. . in the ew, initial vitals were: t 98.2, hr 107, bp 85/61, rr 18, sao2 100% ra. the sbp nadired in mid 70s but responded without treatment sbp 100s. she was started on maintanance fluid for a total of 1l. guaiac positive with maroon stool. ngl with coffee grounds that did not clear after 1l. she was started on pantoprazole gtt. she has 18g x2 for access and was typed and crossed for 2 units. gi was consulted. the patient was sent the micu with vitals: hr 86, sbp 112, rr 13, sao2 100% ra. . currently, the patient notes discomfort from the ng tube. she otherwise feels well. . ros: per hpi. otherwise negative in 10 other systems. past medical history: 1. mild asthma 2. h/o anemia 3. h/o duodenal ulcer, s/p ugib, s/p cauterization, h. pylori positive although no treatment (gi felt that treatment was not warranted) 4. h/o low back pain 5. h/o shingles 6. h/o benign mass in soft palate 7. h/o anxiety 8. h/o gestational diabetes 9. h/o palpitations social history: immunologist. lifelong nonsmoker. she drinks alcohol about one drink (glass of wine) per day. she does not use recreational drugs. family history: htn, hld, cva. 5-healthy siblings. physical exam: admission exam: vs: temp: 97.7 bp: 112/71 hr: 98 rr: 13 o2sat: 100% ra gen: pleasant, comfortable, nad heent: perrl, mmm, op without lesions, no supraclavicular or cervical lymphadenopathy, resp: cta b/l with good air movement throughout cv: rr, nl rate, s1 and s2 wnl, no m/r/g abd: nd, +b/s, soft, epigastric tenderness, no masses or hepatosplenomegaly ext: warm, no c/c/e skin: no rashes/no jaundice/no splinters neuro: aaox3. cn ii-xii grossly intact rectal: per ew guaiac positive dark red stool discharge exam: vitals: 98.7 98/62 60 16 97% ra general: thin, alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear lungs: clear auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: admission labs 02:15pm blood wbc-13.1*# rbc-4.06* hgb-11.8* hct-35.7* mcv-88 mch-29.0 mchc-33.0 rdw-13.9 plt ct-268 02:15pm blood pt-12.5 ptt-27.5 inr(pt)-1.1 02:15pm blood glucose-168* urean-40* creat-0.8 na-139 k-4.0 cl-102 hco3-27 angap-14 02:15pm blood alt-16 ast-21 alkphos-55 totbili-0.3 serial hcts 05:10pm blood hct-29.5* 10:44pm blood hct-25.6* 03:22am blood hct-27.9* 10:20am blood hct-30.7* 05:10pm blood hct-33.9* 06:25am blood wbc-5.7 rbc-3.71* hgb-11.2* hct-32.1* mcv-87 mch-30.1 mchc-34.7 rdw-14.3 plt ct-196 imaging: cxr: impression: no acute cardiopulmonary process. no evidence of free air beneath the diaphragms. egd: -coffee grounds in the stomach -a single 1cm ulcer was found in the proximal bulb. -a small clot/pigmental material was present, which is predictive of the likelihood of rebleeding. -8 cc of epinephrine 1/ was injected circumferentially at the base of the ulcer. -a bipolar gold probe was applied the area for coaptive coagulation of the underlying vessel. -otherwise normal egd 2nd part of duodenum. brief hospital course: 54-year-old female with past medical history of ugib secondary duodenal ulcer, on pantoprazole but not taking it regularly presented with upper gi bleed. . # upper gi bleed with acute blood loss anemia: patient had history of duodenal ulcer and gib. there were no precipitating triggers for this bleed, such as nsaid use, but patient had been not taking pantoprazole consistently. ngl in ed with coffee ground emesis, melena and increased bun/cr ratio. she was started on ppi gtt and underwent egd which revealed a 1cm ulcer in the proximal bulb of the duodenum. this was treated with epinephrine and coaptive coagulation. she received 2 units prbcs for hct drop from 35 25 and had subsequent stable hcts around 30. she was hypotensive overnight on initial evening of admission with sbps 80s but this improved with fluids and prbcs. the patient was transferred from the micu the floor and remained stable. h pylori tested was deferred outpatient. the patient will followup with gi in two weeks; before this she will have h.pylori testing with her pcp. was discharged with strict instructions continue taking pantoprazole 40 mg . . # leukocytosis: the patient presented with leukocytosis of unclear etiology. she had no evidence of infection and cxr without consolidation. her wbc resolved 5.7 on discharge. medications on admission: 1. pantoprazole 40 mg po bid 2. calcium/vit d 500/500 mg/iu po bid discharge medications: 1. 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:*0* 2. outpatient testing please perform urease breath test and h.pylori stool antigen. discharge disposition: home discharge diagnosis: duodenal ulcer with upper gi bleed discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dr. , you were admitted the hospital for an upper gi bleed that was found on endoscopy be secondary a duodenal ulcer. the ulcer was cauterized and injected with epinephrine. . your hct was stable for two days before discharge. please make sure return if you have any recurrent signs of bleeding, including dark stool. you will need followup with gi in 2 weeks; this appointment is listed below. before then, you will need have testing for h.pylori with a urease breath test and h.pylori stool antigen. we will write you a prescription for this and notify your pcp. talk your pcp and make sure this testing is complete before your gi appointment. . you should take the followng medication every day: pantoprazole 40 mg by mouth twice daily. . we have made no other changes your medications. followup instructions: department: when: thursday at 1:40 pm with: post clinic building: sc clinical ctr campus: east best parking: garage department: endo suites when: friday at 1:30 pm department: digestive disease center when: friday at 1:30 pm with: ,md building: building (/ complex) campus: east best parking: main garage department: gastroenterology when: thursday at 10:40 am with: , md building: lm bldg () campus: west best parking: garage procedure: endoscopic control of gastric or duodenal bleeding diagnoses: acute posthemorrhagic anemia asthma, unspecified type, unspecified anxiety state, unspecified chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction hypovolemia leukocytosis, unspecified 

Answer: The patient is high likely exposed to