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: lisinopril attending: chief complaint: rectal bleeding major surgical or invasive procedure: none history of present illness: 81f with atrial fibrillation on coumadin, hep b without esld, s/p colonoscopy 8 days pta, presenting with 7 days of mild rectal bleeding with 2 days of heavier bleeding and finding of low hematocrit as an outpatient. she had routine outpatient colonoscopy at on . daughter reports polyps removed, but report not yet available. she had stopped coumadin prior to procedure, and resumed use the day following her procedure. since the procedure she has noted small amounts of red blood in her stools. then two day ago she had a large bowel movement which was basically all red blood. since then she has had 5 similar bowel movements. no abdominal pain, but notes a gassy feeling. has felt fatigued with activity and daughter notes she slept in today. has had decreased po intake and little interest in food since colonoscopy, but most notably in past 2 days since larger bleeding started. also notes a feeling of her heart pounding earlier today. no chest pain or dyspnea. no fever. no lightheadedness or presyncope. she presented to her pcp today, thought ?related to colonoscopy vs. viral. prescribed lomotil and took one dose today. labs returned with hematocrit of 24.1. she was therefore referred to the ed. . in the ed, initial vs were: t98.1 p71 123/34 16 100% on ra. vital signs remained stable throughout ed course. brb on rectal exam. hct 21.9 and inr 2.4. given 5 mg iv vitamin k, ordered for ffp and typed and crossed for 2 units prbcs. gi paged but have not yet called back. admitted to micu given severity of anemia, age, unclear how fast she is bleeding. . on the floor, patient reports feeling well, just fatigued. no abdominal pain. past medical history: - atrial fibrillation, most recently in sinus. on beta blocker and coumadin. - hepatitis b. no evidence of cirrhosis ever. recent labs () with viral load of 431 and normal lfts. - hypertension - ?past cva or tia (had weakness of fingers of one hand, which resolved) - hyperlipidemia - osteopenia/osteoporosis - ?elevated fasting glucose - "being watched" per daughter. - s/p cataract surgery , no complications. social history: lives with daughter and granddaughter. works full time. - tobacco: remote history of occasional smoking, quit > 45 years ago. - alcohol: none - illicits: none family history: daughter with kidney stones. physical exam: admission exam: general: appears younger than stated age, alert, oriented, no distress. heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvd 2-3 cm asa, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi, some decrease at bases. cv: regular rate and rhythm, normal s1 + s2, soft sm at rusb and at apex. no significant radiation to carotids. 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. neuro: cn ii-xii intact. strength 5/5 in ues and les. pertinent results: admission labs: 08:55pm blood wbc-6.7 rbc-2.36* hgb-7.4* hct-21.9* mcv-93 mch-31.3 mchc-33.7 rdw-13.6 plt ct-216 08:55pm blood neuts-53.0 lymphs-40.0 monos-4.7 eos-1.3 baso-1.1 08:55pm blood pt-25.4* ptt-34.1 inr(pt)-2.4* 08:55pm blood glucose-132* urean-24* creat-0.8 na-139 k-3.8 cl-107 hco3-23 angap-13 08:55pm blood alt-11 ast-20 ld(ldh)-182 alkphos-32* totbili-0.2 06:48am blood ck-mb-4 ctropnt-0.02* (subsequent .01) 06:43am blood calcium-7.8* phos-3.1 mg-2.1 08:55pm blood albumin-3.4* 10:00pm urine color-yellow appear-clear sp -1.008 10:00pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-5.0 leuks-neg discharge and other labs: 07:05am blood tsh-0.59 06:10am blood wbc-7.3 rbc-4.26 hgb-12.2 hct-36.8 mcv-86 mch-28.7 mchc-33.2 rdw-17.0* plt ct-264 06:10am blood pt-17.5* inr(pt)-1.6* 06:10am blood glucose-92 urean-17 creat-0.8 na-143 k-3.9 cl-108 hco3-25 angap-14 07:00am blood ck(cpk)-140 06:10am blood calcium-8.6 phos-3.2# mg-2.1 studies: r ankle x-ray five total images of the right foot and lower leg are submitted. the bones are osteopenic. there is a small ankle joint effusion. there are mild degenerative changes at the tibiotalar joint and talonavicular joint. no acute abnormality is noted. five total images of the right foot and lower leg are submitted. the bones are osteopenic. there is a small ankle joint effusion. there are mild degenerative changes at the tibiotalar joint and talonavicular joint. no acute abnormality is noted. cxr transvenous right atrial and right ventricular pacer leads follow their expected courses from the left axillary pacemaker. no pneumothorax or mediastinal widening is present. lateral view shows a very small pleural effusion collected posteriorly. heart size normal, probable small pericardial effusion projects to the left of the cardiac apex, but there is no mediastinal vascular engorgement to suggest that this is hemodynamically significant. vascular deficiency in the right upper lobe is probably due to emphysema. no focal pulmonary abnormality is seen elsewhere. brief hospital course: 81 yo f with atrial fibrillation on coumadin, chronic hbv without esld, presenting with brbpr s/p colonoscopy one week ago. . # brbpr. presenting with 2 days of painless rectal bleeding, in the setting of having a colonoscopy one week ago - high suspicion for post-polypectomy bleed in the setting of re-starting coumadin as an outpatient, particularly since pt had been having smaller amounts of bleeding since the procedure. no evidence of ischemic colitis. patient was admitted overnight to the micu and made npo while trending her hematocrit. her inr was reversed with vitamin k and ffp. gi saw her and recommended continued supportive management at this time. we obtained osh records that confirmed polypectomy x3 in the cecum. patient was stable throughout the day in the micu and transferred to the floor. patient had one additional episode of bloody bm on the general medicine floor in the setting of ptt >150 while on heparin drip bridging to coumadin, and this resolved when heparin was discontinued. hct was stable and patient did not require any transfusions. she did not have any additional brbpr during her hospital stay. . # atrial fibrillation. on coumadin. patient's anticoagulation was initially held in the setting of acute bleed, but then restarted by the time of patient's discharge from the micu. she was started on metoprolol 25mg (increased from home dose of metoprolol 25mg daily) and was paroxysmally in and out of a fib/flutter throughout her stay on the medicine wards. patient's hr was in the 140's during episodes of a fib/flutter. heart rate responded to iv metoprolol and iv diltiazem, but the patient was seen to have second pauses on telemetry with iv nodal agents. she was seen by her outpatient cardiologist and was scheduled to have a pacemaker placed which was done on . given the patient was only symptomatic from her a fib/flutter was during the initial episode on the floor, and remained asymptomatic with stable bps during her subsequent episodes of a fib/flutter, it was decided to hold off on attempt to rate control prior to placement of pacemaker. after the pacemaker was placed she continued to have afib with rvr without a good response to metoprolol. diltiazem was started with good response. amiodarone loading with 400mg was also started on day of discharge. her inr was not therapeutic at discharge however there was concern of bleeding into the pacemaker pocket if she were bridged with heparin. . # hypertension. normotensive in the micu. bp meds were held in the setting of acute bleed. . # osteoporosis versus osteopenia. fosamax was held while patient was in-house and started at discharge. . #next of : , relationship: daughter phone: other phone: # code: full medications on admission: - coumadin 2.5 mg tue/fri, 2 mg other days - avapro 150 mg daily - metoprolol 25 mg daily - fosamax 70 mg weekly - simvastatin 20 mg daily - multivitamin daily - vitamin d 1000 units daily - fish oil 1000 mg daily discharge disposition: home with service facility: americare at home inc discharge diagnosis: bright red blood per rectum atrial fibrillation/flutter . secondary diagnosis: - hypertension - diet controlled diabetes discharge condition: mental status:clear and coherent level of consciousness:alert and interactive activity status:ambulatory - independent discharge instructions: you presented to the hospital for bloody bowel movements after having a colonoscopy with removal of polyps. you were on blood thinners during this time, which were held initially while you were in the hospital. you were monitored in the intensive care unit and transfused 4 units of blood to bring your blood counts back up. after your blood count stabilized and you did not have any further bleeds, you were transferred to the floor. while on the general medicine floor, you went into atrial fibrillation/flutter, and were given medications to control your heart rate. your blood thinners were re-started. a pacemaker was placed in your chest on since the medications for the atrial fibrillation were causing your heart to beat too slowly. you heart is now beating normally. while you were here some of your home medications were changed. you should continue taking: avapro 150 mg daily fosamax 70 mg weekly simvastatin 20mg daily multivitamin daily vitamin d 1000u daily fish oil 1000u daily you should change: coumadin should now be 2mg every day and not 2.5mg. you should follow the coumadin dosing as prescribed by your coumadin clinic. you should start: -cephalexin, an antibiotic which is given to prevent infection after a procedure. finish the pills in the prescription. -diltiazem 120mg daily -amiodarone 400mg twice a day. take this pill until told to stop by dr. . -tylenol as needed for pain. if that doesn't work you can take oxycodone as prescribed, however do not drive when using this medication. if you have any palpitations or feel your heart is beating funny you should call you dr. at the number below. followup instructions: an appointment has been scheduled for you with your cardiologist, dr. , on at 2pm. your pacemaker will be checked at that time. telephone number . you should have your inr checked your lab or pcp's office on friday . you should follow-up with your primary care doctor, dr. () on at 11am. procedure: initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle diagnoses: unspecified essential hypertension acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled gout, unspecified atrial fibrillation atrial flutter other and unspecified hyperlipidemia hemorrhage complicating a procedure osteoporosis, unspecified blood in stool other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation long-term (current) use of anticoagulants personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits sinoatrial node dysfunction chronic viral hepatitis b without mention of hepatic coma without mention of hepatitis delta disorder of bone and cartilage, unspecified 

Answer: The patient is high likely exposed to