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: methadone attending: chief complaint: hematemasis major surgical or invasive procedure: none at (egd at center) history of present illness: the patient is a 44 year-old male with a history of hemochromatosis, type i diabetes, liver cirrhosis, and alcoholism, who presents with hematemesis. mr. was in his usual state of fair-good health until the morning of , when he describes new fatigue and sweating (with heat intolerance) on awakening. 10-20 minutes later, he reports rapid-onset epigastric abdominal pain (5/10 intensity, sharp quality, non-radiating), with 2 episodes of vomiting large 5-10cm blood clots. at this point, the patient reports feeling mentally "foggy," with moderate dizziness and mild shortness of breath. ems was called, and the patient was brought by ambulance to hospital (). the patient reports two episodes of nosebleed over the past week (compared to no bleeding at baseline). he reports his last drink ( shots whisky) was on the night prior to the present episode. he denies loss of conciousness, tremor, itchiness, hematochezia, melena, changes in vision or hearing, previous episodes of hematemesis, recent abdominal pain, or recent history of vomiting. . at the osh, the patient vomited copious amounts of bright red blood ("filling vomit bags"). sbp was down to 80-90s, with hct 33 and glucose 450. stool was guaiac + . he received fluids, 2 units packed rbcs, protonix iv q12, ciprofloxacin, octrotide, vit k, and humalog (10 units x2). an egd revealed esophageal varices (grade 4). variceal banding was performed, and the patient was transferred to on for further management. . in the micu, the patient had t 36.4 p 72 bp 83-103/62 rr 16 sao2 94 % (ra), with one initial episode of nausea and small coffee-ground emesis. hct was 32.4 on admission (low of 25.8). he was observed for --- hours, found to be hemodynamically stable, and transferred to the floor. . on the floor, the patient reports good appetite, with no residual nausea, abdominal pain, dizziness, or fatigue. hct was up from 25.8 to 28. he denies further vomiting episodes. . . ros: the patient reports a new-onset sore throat on (two days prior to presentation), with swollen glands. he denies new onset nausea/vomiting. the patient experienced a motorcycle accident 3 weeks prior to admission (cycle drove through garage door). he reports trauma to his nasal cartilage, but denies known abdominal or chest trauma. he reports a recent weight gain of 6 pounds (from 166-172) over the past 3 weeks. the patient reports a mild cough over the past 4-5 months (denies hemoptysis). over the past 1-2 weeks, the patient notes small undigested pieces of vegetables (e.g. carrots) in his stool (which he attributes to a new-onset difficulty of digestion). review of systems was otherwise negative except as specified in the hpi (specifically, the patient denies change in po intake of foods/ fluids, new joint pains, dysuria, hematuria, new rashes/bumps, diarrhea/constipation). past medical history: 1. hemochromatosis (diagnosed . pt. reports hx of multiple episdoes of hepatic encephalopathy requiring 3+ hospitalizations, esophageal varices , no history bleeding], bronze color changes of skin , diabetes , history of pancreatic inflammation. no noted history of adrenal insufficiency, arthritis, heart failure. treated with phlebotomy). 2. cirrhosis (diagnosed . noted features include ascites, palmar erythema, mild gynecomastia, hx episdoes hepatic encephalopathy) 3. alcohol abuse (chronic, long-standing. pt. reports drinking shots whisky per day) 4. type i diabetes (pt. uses glargine + lispro insulin at home) 5. peptic ulcer disease (diagnosed , no history bleed. patient put on omeprazole) 6. ventral hernia 7. bronchial asthma (since youth. triggered by cold temperatures. pt. uses advair inhaler 1x/day). 8. multiple episodes of pneumonia (during childhood) 9. chronic incontinence of stool (during childhood) 10. peripheral neuropathy (affecting bilateral lower extremities. "aching" pain extending from the hips down to the distal les). 11. depression (details not obtained) 12. bone spurs in neck (details not obtained) social history: patient lives at home with his wife, , and mother. used to work as a truck driver, and subsequently owned a construction business (currently retired / not working). father recently died (within past year) from liver cancer and cirrhosis. pets at home: 3 dogs, 5 cats, 3 birds, 1 fish. etoh: patient drinks 2-3 shots whisky per day smoking: patient has smoked for 35 years (up to 5 ppd, currently ppd). quit yesterday. illicits: pt. reports occasional marajuana use. family history: father: liver cancer (died within past year at age 67), cirrhosis patient's maternal grandmother: cancer (unknown type) cousin: diabetes, cad cousin: laryngeal cancer physical exam: on transfer to floor: vitals: t 97.9 bp 100/68 hr 60 rr 18 sao2 96 % (ra) general: patient is comfortable, nontoxic, in no apparent distress. neuro: aaox3. peerla (pupils 4mm, equal). eomi, no nystagmus. visual fields intact, tongue midline. good finger-to-nose. face symmetric. strength 5/5 x4. no asteryxis. no pronator drift. skin: warm and well perfused. moderate palmar erythema bilaterally. tattoos on arms bilaterally. bronze coloration of dorsal surface of hands, ? of mild bronze coloration of skin diffusely. 1cm round pitted scar region on left arm. multiple 1cm pitted scars on back. multiple prominent closed/open comedones on back. no rash/ petechiae/ ecchymosis. heent: sclera anicteric. oral mucosa pink. dentition absent (patient uses dentures). trachea midline. neck supple, with full rom. thyroid non-enlarged. lymphatic: no cervical or supraclavicular lymphadenopathy. pulmonary: lung sounds clear to ascultation bilaterally. no crackles/wheezes/rhonchi. cardiac: regular rate and rhythm. no murmurs/rubs/gallops. pmi was firmly tapping, quarter-sized, located btwn 4-5th intercostal space along midclavicular line. gi: +bowel sounds. abdomen soft, moderately distended (ascitic). nontender. liver edge palpable at 2-3 cm below costal margin. no splenomegaly. extremities: wwp. no clubbing. radial and dp pulses 2+ bilaterally. no edema. rom intact. . pertinent results: from osh: inr 1.8 hct 33, 33 plt 82 na 134, k 4.4, cl 95, bicarb 29, bun 20, cr 1.1, glucose 391; ag 10 ast 63, ast 38 tbili albumin 2.5 . ekg: nsr, no ischemia . . 12:42am blood wbc-5.1 rbc-3.67* hgb-10.8* hct-32.4* mcv-89# mch-29.3 mchc-33.2 rdw-17.9* plt ct-67* 12:42am blood pt-21.1* ptt-31.8 inr(pt)-2.0* 12:42am blood glucose-396* urean-31* creat-0.8 na-140 k-4.5 cl-103 hco3-23 angap-19 12:42am blood alt-24 ast-55* ld(ldh)-212 alkphos-120* totbili-7.2* 12:42am blood albumin-2.8* calcium-7.5* phos-5.0* mg-1.6 . . cxr: portable ap chest radiograph was reviewed with no prior studies available for comparison. heart size is normal. mediastinal position, contour and width are unremarkable. left retrocardiac opacity might be consistent with aspiration versus atelectasis and is involving relatively small area of the lung. the rest of the lungs are grossly unremarkable. no appreciable pleural effusion is seen. there is no pneumothorax. no evidence of pulmonary edema is present. 08:06pm hct-27.3* 01:00pm hct-28.3* 07:44am glucose-234* urea n-25* creat-0.7 sodium-142 potassium-3.9 chloride-107 total co2-28 anion gap-11 07:44am hct-27.7* 07:44am pt-18.8* ptt-29.5 inr(pt)-1.7* 12:42am glucose-396* urea n-31* creat-0.8 sodium-140 potassium-4.5 chloride-103 total co2-23 anion gap-19 12:42am estgfr-using this 12:42am alt(sgpt)-24 ast(sgot)-55* ld(ldh)-212 alk phos-120* tot bili-7.2* 12:42am albumin-2.8* calcium-7.5* phosphate-5.0* magnesium-1.6 12:42am wbc-5.1 rbc-3.67* hgb-10.8* hct-32.4* mcv-89# mch-29.3 mchc-33.2 rdw-17.9* 12:42am plt count-67* 12:42am pt-21.1* ptt-31.8 inr(pt)-2.0* . liver u/s with no portal venous thrombosis on prelim read brief hospital course: this is a 44 year-old male with a history of hemochromatosis, cirrhotic liver disease, and known grade 4 esophageal varices (diagnosed in ), who presents with hematemesis. in the osh, egd was performed revealing active bleeding. since banding was performed, the patient has remained hemodynamically stable, with one episode of coffee-ground emesis (likely from residual blood in the stomach), but no further bright red blood. in this patient alcoholic liver damage and damage from iron deposition both contribute to liver disease and esophageal varices (via the effect on portal pressures). the plan for management should include risk reduction for further variceal bleeds, and should also include social work/ counceling for cessation of alcohol intake. . # hematemasis: grade 4 variceal bleeding on osh egd, s/p banding, was not hd stable at osh but bp has improved to sbp 98-105, map 70. hcts and hd stable here. continued on iv ppi , octreotide gtt, and cipro iv for sbp prophylaxis. hepatology consult team was following, who felt that another egd would not be needed urgently but should be done soon as an outpatient. he was restarted on low-dose po nadolol once tolerating a clear liquid diet and was advanced to a regular diet before transfer to the floor. he tolerated po well and was discharged on half his dose of nadolol given pressures in the high 90-100 range. he will have his hct checked at his pcp or dr. office in 1 week, will f/u with dr. in 2 weeks, and will have a repeat egd at that time. . # cirrhosis: meld 18-> 23. no evidence of acute hepatitis but cr, inr and t.bili are elevated. he was continued on lactulose and vitamins, but his spironolactone was held in the setting of the variceal bleeding and restarted on day of discharge. . # dm, type 1: high blood sugars but no gap, fs on admission here 370's. he reportedly is non-compliant with diabetic diet and insulin for blood sugar control. he was continued on his home dose of lantus and monitored with a sliding scale. he was also continued on gabapentin and prn ultram for his neuropathy once taking pos. . # arf: baseline cr 0.7, 1.1 at osh, likely secondary to hypotension and recent poor intake; already received fluids and 2 units prbc's. stable. . # depression: citalopram restarted once taking pos. medications on admission: citalopram - 20 mg tablet - tablet(s) by mouth once a day gabapentin - 100 mg capsule -100 mg po take 2 at bed time insulin glargine - 44 units once a day insulin lispro - (prescribed by other provider) - dosage uncertain lactulose - 10 gram/15 ml 30 cc by mouth 3-5 times daily nadolol - 40 mg tablet - 1 tablet(s) by mouth twice a day omeprazole - 20 mg capsule, delayed release(e.c.) - 1 capsule(s) by mouth once a day spironolactone - 25 mg tablet - 1 tablet(s) by mouth twice a day testosterone dosage uncertain tramadol 50 mg tablet - 1 tablet(s) by mouth twice a day multivitamin - (prescribed by other provider) - capsule - 1 capsule(s) by mouth once a day discharge medications: 1. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po tid (3 times a day) as needed: titrate to 3 bm's daily . 2. nicotine 14 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily). disp:*30 patch 24 hr(s)* refills:*2* 3. nadolol 20 mg tablet sig: one (1) tablet po bid (2 times a day). 4. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 5. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. disp:*60 capsule, delayed release(e.c.)(s)* refills:*2* 6. multivitamin tablet sig: one (1) tablet po daily (daily). 7. spironolactone 25 mg tablet sig: one (1) tablet po bid (2 times a day). 8. gabapentin 100 mg capsule sig: two (2) capsule po hs (at bedtime). 9. insulin glargine 100 unit/ml solution sig: forty three (43) units subcutaneous once a day. 10. insulin lispro 100 unit/ml solution sig: as directed units subcutaneous qachs: take as directed before meals and at bedtime per sliding scale. 11. testosterone transdermal 12. tramadol 50 mg tablet sig: one (1) tablet po twice a day as needed for pain. discharge disposition: home discharge diagnosis: primary: upper gi bleed from esophageal varices liver cirrhosis type 1 diabetes . secondary: depression discharge condition: good, vss, afebrile, tolerating po well, no further hematemesis discharge instructions: you came to the hospital after you vomited blood. at an outside hospital, they did an egd which showed esophageal varices (dilated veins) which were causing the bleeding. bands were placed on these and this stopped the bleeding. an ultrasound showed you have no clot in your portal vein. you will need to have a repeat egd by dr. in 3 weeks. you should quit drinking alcohol to help prevent repeat episodes of this. . medication changes: - your nadolol was cut in half, please take 20 mg twice daily until you see dr. . - please place your nicotine patch daily to help you quit smoking. - please take your other medications as prescribed. . please call your doctor or return to the ed if you have more bloody vomit, dizzyness/lightheadedness, black or bloody stools, abdominal pain, chest pain, shortness of breath, or other concerns. followup instructions: please call your primary care doctor or dr. to have your hematocrit checked within 1 week. . provider: (st-3) gi rooms date/time: 9:00 provider: , md phone: date/time: 9:00 provider: , md phone: date/time: 3:20 procedure: transfusion of other serum diagnoses: alcoholic cirrhosis of liver acute kidney failure, unspecified depressive disorder, not elsewhere classified long-term (current) use of insulin esophageal varices in diseases classified elsewhere, with bleeding diabetes mellitus without mention of complication, type i [juvenile type], not stated as uncontrolled unspecified hereditary and idiopathic peripheral neuropathy other and unspecified alcohol dependence, unspecified peptic ulcer of unspecified site, unspecified as acute or chronic, without mention of hemorrhage or perforation, without mention of obstruction ventral, unspecified, hernia without mention of obstruction or gangrene exostosis of unspecified site 

Answer: The patient is high likely exposed to