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: vaginal bleeding major surgical or invasive procedure: turbt history of present illness: this is a 79 year-old female with a history of pvd, af, who presents with vaginal bleeding. the patient reports being in her usual state of health until this am when she started to bleed. per report the patient had ongoing vaginal bleeding with passing large clots. she then went to dialysis but continued to have bleeding. she then went to the er with this ongoing bleeding . in the ed, initial vitals were t 97 bp 109/54 hr 112, rr 16 02 97% ra. patient was reportedly seen by urology and is to be admitted to the for evaluation of the bleeding. . ros: the patient denies any fevers, chills, weight change, nausea, vomiting, abdominal pain, diarrhea, constipation, melena, hematochezia, chest pain, shortness of breath, orthopnea, pnd, lower extremity edema, cough, urinary frequency, urgency, dysuria, lightheadedness, gait unsteadiness, focal weakness, vision changes, headache, rash or skin changes. past medical history: 1. pvd with right lower extremity non-healing ulcers 2. hypercholesterolemia 3. esrd on hd 4. atrial fibrillation 5. dm 6. depression 7. hypothyroidism 8. bladder ca 9. constipation 10. anemia psh: r fem-ak bpg (6 years ago); r groin exploration with r eia/profunda/fem- bpg thrombectomy, r cfa & eia dacron patch angioplasty, rle 4 compartment fasciotomies ; r pfa & fem- thrombectomy, fem- angioplasty x 2, fem- stent x 2 ; hysterectomy, c-section social history: has daughter and son, smoked 1 ppd, stopped 8 years ago, lives alone but currently at , hcps are son ) and daughter () family history: non-contributory physical exam: gen: well-appearing, well-nourished, no acute distress heent: eomi, perrl, sclera anicteric, no epistaxis or rhinorrhea, mmm, op clear neck: no jvd, carotid pulses brisk, no bruits, no cervical lymphadenopathy, trachea midline cor: rrr, no m/g/r, normal s1 s2, radial pulses +2 pulm: lungs ctab, no w/r/r abd: soft, nt, nd, +bs, no hsm, no masses ext: no c/c/e, no palpable cords neuro: alert, oriented to person, place, and time. cn ii ?????? xii grossly intact. moves all 4 extremities. strength 5/5 in upper and lower extremities. patellar dtr +1. plantar reflex downgoing. no gait disturbance. no cerebellar dysfunction. skin: no jaundice, cyanosis, or gross dermatitis. no ecchymoses. pertinent results: 03:40pm pt-13.4 ptt-31.1 inr(pt)-1.1 plt smr-normal plt count-320 hypochrom-2+ anisocyt-2+ poikilocy-1+ macrocyt-2+ microcyt-1+ polychrom-1+ target-occasional schistocy-occasional stippled-occasional pappenhei-occasional envelop-1+ neuts-84.3* bands-0 lymphs-10.7* monos-3.1 eos-1.6 basos-0.3 wbc-7.5# rbc-3.05* hgb-9.3* hct-29.4* mcv-96 mch-30.5 mchc-31.6 rdw-20.1* calcium-9.0 phosphate-4.3 magnesium-1.9 glucose-183* urea n-19 creat-3.0* sodium-140 potassium-4.7 chloride-99 total co2-32 anion gap-14 hgb-11.2* calchct-34 ct abdomen w/contrast study date of 6:37 pm conclusion: 1. urinary bladder tumor and likely hemorrhage. it is technically difficult to assess the exact extent of the tumor due to surrounding hemorrhage, though the mass approximately measures 52 x 31 mm, previously 40 x 26 mm. 2. air within the urinary bladder, if no recent instrumention fistulous communication is a concern. 3. multiple cystic lesions in the pancreas likely representing side branch ipmns. no associated pancreatic ductal dilatation. an mrcp would be helpful for further characterization. 4. extensive atherosclerosis in the coronary arteries as well as the abdominal and pelvic vasculature with an occluded right superficial femoral artery as well as occlusion of the native right superficial femoral artery. 5. indeterminate tiny hepatic hypodensities were barely visualized on the prior examination due to different phase of contrast. a liver ultrasound would be helpful for further characterization of these or alternatively these can be assessed at the time of the mrcp. brief hospital course: this is a 79 year-old female with a history of pvd, bladder cancer, a fib, esrd who presents with persistent vaginal bleeding . # vaginal bleeding/tachycardia/hypotension:: based on history the patient was reported to lose a significant amount of blood. initial repeat hct stable at 29. nonetheless, the patient had ongoing blood loss, hypotension and intermittent tachycardia and was admitted to the. coag studies were wnl. ct scan showed bladder mass which was considered the cause of bleeding. the patient recieved a total of 3u rbc and was subsequently stable. tachcardia and hypotension improved with transfusion of blood and was likely secondary to blood loss. hematocrit was ********the day of discharge. # bladder mass: the patient's bleeding was suspectd to be due to a bladder mass eroading through the bladder wall. the patient underwent cystoscopy with subseqent biopsy of the bladder mass. pathology results were pending at the time of discharge. # pvd/ s/p debridement: pt has wound appears to be healing with good granulation tissue and minimal evidence for infection. will have wound care evaluate the patient in am. will consider plastics consult if worsening. holding aspirin for now given . # atrial fibrillation: patient is rate controlled without meds currently. given the patient's hypotension, will not add betablockers at this time, but will add back when bleeding stable. not currently on anticoagulation . # diabetes: patient reports having diet controlled diabetes. will give patient insulin sliding scale at this point and diabetic diet. hypotensive with sbps in the 80's. mentating well. did not respond to fluids. had post transfusion hct with minimal increase. recieved 1u rbc with hct from 29-->30 - urology - npo mn, plan for proecedure - picc line placed - renal - hd tommorow, ? prbc during hd (per icu team) - hct - 29 > 30 (s/p 1 uprbc) > 24.1 > 23.8 > 25.1 (post-transfusion 1 u prbc) - anesthesia contact re: procedure and aware of pt for tommorow's procedure - contact and aware of pt (no official consult requested) - 1.44 second sinus pause on telemetry (astymptomatic) o/n turbt procedure, transferred back to icu in stable condition transferred to floor discharge medications on admission: albuterol aspirin 81 mg daily atorvastatin 10 mg daily brimodine carvediolol 12.5 furosemide 60 mg ,tu,th,sa insulin sliding scale metoclopramide micanazole mvi scopolamine sevelamer 800 tid vit b percocet 1 tab this pm discharge medications: 1. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 2. miconazole nitrate 2 % powder sig: one (1) appl topical (2 times a day) as needed. 3. sevelamer hcl 800 mg tablet sig: one (1) tablet po tid w/meals (3 times a day with meals). 4. b complex vitamins capsule sig: one (1) cap po daily (daily). 5. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 6. oxycodone 5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed. 7. carvedilol 12.5 mg tablet sig: two (2) tablet po bid (2 times a day). 8. furosemide 20 mg tablet sig: three (3) tablet po sunday, tuesday, thursday, saturday (). 9. bactrim 1 tab po bid discharge disposition: extended care facility: & rehab center - discharge diagnosis: bladder tumor discharge condition: stable discharge instructions: - resume home medications - keep foley catheter in until saturday at which point it can be removed - return to emergency room for further bleeding, vomitting, or other concerns - f/u with dr. followup instructions: 2 weeks procedure: venous catheterization, not elsewhere classified hemodialysis transfusion of packed cells other transurethral excision or destruction of lesion or tissue of bladder closed [transurethral] biopsy of bladder diagnoses: end stage renal disease renal dialysis status pure hypercholesterolemia acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism atrial fibrillation depressive disorder, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease pressure ulcer, other site pressure ulcer, lower back pressure ulcer, heel atherosclerosis of native arteries of the extremities with ulceration pressure ulcer, stage iv acquired absence of both cervix and uterus malignant neoplasm of other specified sites of bladder 

Answer: The patient is high likely exposed to