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: coffee ground emesis major surgical or invasive procedure: egd history of present illness: 75 y/o m with h/o remote traumatic brain injury, htn, and h/o barrett's esophagous presents from nursing home after witnessed coffee ground emesis x 1. he was found the morning of admission with coffee grinds on pillow. when the nursing home staff got him up for the day he had one episode of emesis that was noted to be dark black and a large dark brown bowel movement without any bright red blood and he was transferred to ed. . in the emergency department, vs were t 97.6 hr 83 bp 179/89 rr 20 pox 100 on ra. his exam was remarkable for pale appearing, benign abdomenal exam, and guiac negative stool. he received 1l ns and was typed and cross with plan 2 units. two 18g pivs were placed. he received 40mg iv pantoprazole and iv zofran. an ng levage was attempted with induction for emesis with return of coffee grounds and ng tube was placed to suction. gi was consulted with plan for egd in the micu. prior to transfer to the , hr 120, w/ frequent pvcs/bigeminy, and sbp 130s. . history was obtained from care givers and medical record due to patient's baseline mental status. . on arrival to the , patient reported no nausea, abdominal pain, chest pain, difficulty breathing. he states he has a long-standing cough unchanged from baseline. past medical history: - complex regional pain syndrome - traumatic brain injury s/p remote mvc, slurred speech at baseline - prostate ca (--operated by dr. ) - cri (baseline cr 2-2.2) - h/o gi bleed admitted --egd with esophagitis - iron deficiency anemia - thrombocytopenia - htn - incontinence. social history: tob x 15 yrs (stopped 40 yrs ago), no etoh recently (though may have had etoh hx), no ivdu, lives at , has home health aides on the weekend. per hha, was in mva in 50's and had brain injuries. sister is : family history: none per pt physical exam: general: pleasant, well appearing elderly male in nad heent: normocephalic, atraumatic. no conjunctival pallor. no scleral icterus. perrla/eomi. mmm w/ some coffee ground remains. op clear. ng tube in place draining coffee grounds. neck supple, no lad, no thyromegaly. cardiac: regular rhythm with occasional premature beats, normal rate. normal s1, s2. no murmurs, rubs or . lungs: wet cough, rhoncorus throughout, good air movement biaterally, no wheezing. abdomen: distended, nabs. soft, nt. no hsm appreciated extremities: no edema or calf pain, 2+ dorsalis pedis/ posterior tibial pulses. right wrist contraction. right ankle surgical scar. skin: no rashes/lesions, ecchymoses. neuro: a&ox3. appropriate. slurred speech. cn 2-12 grossly intact. gait assessment deferred psych: listens and responds to questions appropriately, pleasant pertinent results: 10:32pm hct-38.5* 12:09pm comments-green top 12:09pm hgb-13.9* calchct-42 12:05pm glucose-178* urea n-43* creat-1.6* sodium-140 potassium-4.2 chloride-106 total co2-23 anion gap-15 12:05pm estgfr-using this 12:05pm alt(sgpt)-23 ast(sgot)-16 ck(cpk)-91 alk phos-78 tot bili-0.4 12:05pm lipase-13 12:05pm ctropnt-0.04* 12:05pm ck-mb-notdone 12:05pm wbc-12.4*# rbc-4.49* hgb-13.5* hct-40.4 mcv-90 mch-30.1 mchc-33.5 rdw-13.3 12:05pm neuts-95.1* lymphs-2.5* monos-2.1 eos-0.1 basos-0.2 12:05pm plt count-192 12:05pm pt-13.8* ptt-24.0 inr(pt)-1.2*. h pylori serology negative . egd : segmental erythema and erosion of the mucosa were noted in the antrum. these findings are compatible with erosive gastritis. duodenum: normal duodenum. impression: ulcers in the lower third of the esophagus medium hiatal hernia erythema and erosion in the antrum compatible with erosive gastritis mucosa suggestive of barrett's esophagus otherwise normal egd to second part of the duodenum recommendations: ppi check h-pylori serology and treat if positive. schedule a f/u appt with dr. in 6 weeks to aarange for a repeat egd and biopsy of esophagus. clinic# avoid asa and nsaids. . cxr : frontal chest radiograph: the cardiomediastinal silhouette is unchanged. mild indistinctness of the pulmonary vessels and perihilar haziness is consistent with a mild degree of interstitial edema. there is no focal consolidation,pneumothorax or pleural effusion. impression: mild interstitial edema. . tte : the left atrium is elongated. left ventricular wall thicknesses and cavity size are normal. there is mild regional left ventricular systolic dysfunction with inferolateral hypokinesis and basal inferior hypokinesis. the remaining segments contract normally (lvef = 45%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. the pulmonary artery systolic pressure could not be determined. there is a trivial/physiologic pericardial effusion. impression: mild regional left ventricular systolic dysfunction, c/w cad. suboptimal study. . cxr : pa and lateral chest, history: mild wheezing. history of asthma, suspect chf. impression: pa and lateral chest compared to : lungs are fully expanded and clear. heart size is normal and there is no pleural effusion. previous vascular congestion has cleared since . there is no pulmonary edema. brief hospital course: this is a 75 yo m with remote traumatic brain injury who presented with hematemesis. . #. upper gi bleed: pt presented with complaints of coffee ground emesis and dark stools. he received 2 u prbc on arrival to the ed and was admitted to the icu for further monitoring. he had no further episodes of bleeding s/p egd on which revealed esophageal ulcers, gastritis, and esophagus. his hct remained stable at 38. he was treated with a ppi . h pylori serology was negative. he has required no further transfusions and hct has remained stable. he should remain off any aspirin or ibuprofen/motrin etc. until follow up with gi in 6 weeks. . # leukocytosis: wbc on admission was 12.5, possibly secondary to stress response. he had no fever and no infiltrate on cxr to suggest pneumonia. leukocytosis resolved. . #. htn: on admission pts lisinopril was initially held. he was restarted on it, but his sbp remained elevated up to 170-180. his lisinopril was increased to 20 mg daily and he was started on toprol xl 12.5 mg daily (as tte noted changes consistent with cad so he would benefit from being on a beta blocker). sbp the following day was only 100 and creatinine rose from 1.3 to 1.7, so his lisinopril was decreased back down to 5 mg daily. with the addition of the toprol, bp was well controlled in the low 100s. . # acute systolic chf: pt had noted mild interstitial edema on admission cxr. on transfer from the icu to the floor, the pt was noted to have wheezing and was satting 93% ra at rest. bnp was elevated at 1527. he did not appear to be in any respiratory distress. tte showed pt has an ef of 45% with mild regional left ventricular systolic dysfunction with inferolateral hypokinesis and basal inferior hypokinesis (consistent with cad). the patient was given lasix 10 mg iv x1 on and again on . toprol xl 12.5 mg daily was started. repeat cxr on showed no further pulmonary edema. will not send pt out on lasix at this time as pt likely had acute failure due to ivf and prbc he received while here. . # cad: not noted history of this on admission, but tte is consistent with cad. asa is being held in setting of recent gi bleed and pts pcp will need to determine appropriate timing to reinitiate. continued lisinopril, started toprol xl for both cad and systolic chf. pt is already on a statin. . # hypernatremia: na noted to be 146 on . given d5w and na normalized. . # deconditioning: the pt was seen by pt on and felt that pt needed either 24 hour care with home pt vs. placement. family and pt were agreeable to placement. . # h/o iron deficiency anemia: continued ferrous sulfate . #. s/p traumatic brain injury: baseline slurred speech and poor historian, has guardian in place . # chronic pain syndrome: continued home lyrica, qam tylenol . #. chronic kidney failure: pts baseline creatinine is 1.5. his creatinine varied from 1.3-1.7 while here. creatinine was 1.5 on day of discharge. . # h/o bph: continued flomax . # dispo: pt discharged to rehab in stable condition. medications on admission: asa 81mg daily iron lisinopril 5mg daily fortical nasal spray in alternate nostrils daily -gay ointment to right foot prn simvastatin 20mg qhs aspirin 81mg daily docusate 100mg ferrous sulfate one po daily prilosec 20mg daily vitamin d 800 units daily azo cranbery one tablet acetaminophen 1000mg q7am folic acid 1mg daily flomax 0.4mg qhs lyrica 50mg discharge medications: 1. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po daily (daily): this is iron supplements and can be purchased over the counter. 2. prilosec 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* 3. fortical 200 unit/actuation aerosol, spray sig: one (1) spray nasal once a day: spray in alternate nostrils daily. 4. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 5. colace 100 mg capsule sig: one (1) capsule po twice a day. 6. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 7. calcium 600 600 mg (1,500 mg) tablet sig: one (1) tablet po twice a day: this can be purchased over the counter. 8. folic acid 1 mg tablet sig: one (1) tablet po once a day. 9. tamsulosin 0.4 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po hs (at bedtime). 10. pregabalin 25 mg capsule sig: two (2) capsule po bid (2 times a day). 11. acetaminophen 500 mg tablet sig: two (2) tablet po once a day. 12. metoprolol succinate 25 mg tablet sustained release 24 hr sig: 0.5 tablet sustained release 24 hr po daily (daily). disp:*15 tablet sustained release 24 hr(s)* refills:*2* 13. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed. 14. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). discharge disposition: extended care facility: & retirement home - discharge diagnosis: hematemesis esophagitis/gastritis gi bleed acute systolic congestive heart failure hypertension discharge condition: stable, hematocrit stable discharge instructions: you were admitted with hematemesis (vomiting blood) and dark stools. you were given 2 units of blood when you first arrived and your were initially admitted to the intensive care unit. you had an upper endoscopy which showed you have inflammation of you stomach and esophagus, and you have ulcers in your esophagus. . you were on a medication called prilosec. this has been increased to 40 mg twice a day to help protect your stomach. . your blood pressure was noted to be high. you were started on another blood pressure medication called toprol xl. . you were noted to have acute congestive heart failure (mild). you were given a medication called lasix to help you urinate off the extra fluid in your lungs. you were also started on a medication called toprol xl (which is a blood pressure medication) to help control your heart failure. you should weigh yourself everyday. if you gain more than 3 lbs or note increased wheezing, you need to call your doctor. you should try to consume a low sodium diet (no more than grams of sodium a day). . you should not take your aspirin anymore until instructed to do so by your doctors it to your ulcers/gi bleeding. . your primary care doctor should follow you at your nursing home after discharge from rehab. you need to follow up with dr. of gi as scheduled. . call your doctor or return to the er for any recurrent vomiting with blood, bloody or black stools, abdominal pain, chest pain, shortness of breath, worsening wheezing, fever, or any other concerning symptom. followup instructions: gi followup: provider: , md phone: date/time: 1:30 md procedure: other endoscopy of small intestine diagnoses: congestive heart failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified personal history of malignant neoplasm of prostate chronic kidney disease, unspecified iron deficiency anemia, unspecified hyperosmolality and/or hypernatremia acute on chronic systolic heart failure unspecified gastritis and gastroduodenitis, without mention of hemorrhage barrett's esophagus ulcer of esophagus with bleeding 

Answer: The patient is high likely exposed to