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: lactose attending: chief complaint: gi bleed major surgical or invasive procedure: three units of blood transfusion () esophagealgastroduodonoscopy with placement of a clip on duodenal ulcer () abdominal ultrasound history of present illness: this is a 75 year old male with pmh of diffusely metastatic prostate cancer s/p orchiectomy and his 5th cycle of taxotere chemotherapy/neulasta in , diabetes, and h/o mssa bacteremia s/p antibiotic treatment in presenting with 1 episode of black stools this am, hct drop from 25.7 to 19.6, and a small amount of dark emesis this am. the patient does not have any prior history of upper or lower gi bleeding, no etoh history, or liver disease and has never been scoped at . the patient reports that he had a normal bowel movement at 5:30 am and then again at 7:30 am. at the time of his 7:30 am bowel movement, the patient became nauseous and vomited a small amount of dark emesis. he does report some wretching, but denies any bright red blood in the emesis. following the emesis he was given gatorade, a cookie, and zofran which helped his nausea. he did report some lightheadedness when he was walking back to his room from the bathroom using his walker. at 9:30 am he called out from his room and his family found him lying in a pool of black liquid stool. he had never been incontinent of stool in the past. he also reported lightheadedness and dizziness if he sat up straight after this episode. of note, the patient took a 2 week course of naproxen for joint pain, but has not taken any naproxen or other nsaids for the last week. he also takes asa 81mg daily and receives steroids with his chemo cycles. he also took his home beta blocker this morning. he does not report having any abdominal pain and has not had a bowel movement since his dark black stool this am. he is followed by dr. and from hem/onc. . in the ed, initial vs: t=97.8, hr=80, bp=116/43, rr=16, pox=98% on ra. an ng lavage was performed which revealed coffee grounds that cleared after 500cc of lavage. a rectal exam revealed melena. he remained hd stable and gi was consulted. an ekg showed nsr at 84 with poor r wave progression but no acute ischemia. he received 1 unit of prbcs in the ed and has 2 peripheral ivs (an 18g and a 20g). he also was started on a protonix drip. his hcp who is his son confirms that the patient is full code. his transfer vitals was bp=120/40, hr=81, and pox=99% ra. . on the floor, the patient reports no abdominal pain or repeat nausea, vomiting, or bowel movements. he remains lightheaded when sitting upright. . review of systems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denies cough, shortness of breath, or wheezing. denies chest pain, chest pressure, palpitations, or weakness. denies abdominal pain, dysuria, frequency, or urgency. denies rashes or skin changes. past medical history: past oncologic history: metastatic prostate cancer . other past medical history: mitral valve prolapse diabetes hyperlipidemia mssa bsi past surgical history: s/p orchiectomy . social history: he emigrated from on in order to be closer to his sons. is a retired corporate attorney, a business executive and a diplomat. he currently lives with his son in , . his son is a professor business school. he has never smoked or drank alcohol and has never used recreational drugs. he is vegetarian. he plans to reside in the united states for this foreseeable future. family history: there is no known family history of cancer. his father died at the age of 78 from an mi. his mother died at the age of 69 of an mi and was obese. he has three brothers who are all healthy. he has two sisters, one who died in her 60s. he has two sons who are both healthy. physical exam: admission exam vitals: t: 96, bp: 109/41, p: 82, r: 18, o2: 99% ra general: alert and oriented; chronically ill appearing, cachectic male in no acute distress heent: sclera anicteric, dry mm, oropharynx clear neck: supple, jvp not elevated lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, 2/6 sem radiating to axilla abdomen: soft, non-tender, non-distended, loud abdominal bruit and pulsations felt centrally in his abdomen, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused; no clubbing, cyanosis, or edema neuro: a+ox3, cn ii-xii intact, motor strength and sensory grossly equal and intact bilaterally . discharge exam vitals: tm:98.9 tc: 98.2, bp: 110/58 (98-121/48-62), p: 76 r: 16, o2: 99-100% ra general: alert and oriented; chronically ill appearing, cachectic male in no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, 2/6 sem radiating to axilla abdomen: soft, non-tender, non-distended, loud abdominal bruit and pulsations felt centrally in his abdomen, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused; no clubbing, cyanosis, or edema neuro: a+ox3, cn ii-xii intact, motor strength and sensory grossly equal and intact bilaterally pertinent results: admission labs 11:35am blood wbc-21.6* rbc-2.16* hgb-6.4* hct-19.6* mcv-91 mch-29.8 mchc-32.9 rdw-15.3 plt ct-172 11:35am blood neuts-90.8* lymphs-7.6* monos-1.3* eos-0.1 baso-0.2 11:35am blood pt-14.9* ptt-24.3 inr(pt)-1.3* 11:35am blood glucose-206* urean-45* creat-1.0 na-136 k-4.8 cl-105 hco3-19* angap-17 11:35am blood calcium-8.5 phos-3.1 mg-2.3 . egd () impression: ulcers in the antrum and stomach body (endoclip) erosions in the antrum ulcers in the duodenal bulb otherwise normal egd to second part of the duodenum recommendations: numerous ulcers and erosions noted in gastric body, antrum and duodenal bulb. ulcer with visible vessel noted in pyloric channel non bleeding s/p endoclip. consistent with nsaid induced peptic ulcer disease as culprit for bleed. please continue iv bid ppi. hold nsaids. check h-pylori antibody and treat if positive. . ecg study date of 11:28:16 am normal sinus rhythm. borderline atrio-ventricular conduction delay. non-specific t wave flattening. compared to the previous tracing of no diagnostic interim change. intervals axes rate pr qrs qt/qtc p qrs t 84 196 74 400/442 53 73 31 . aorta and branches study date of 11:04 am findings: the visualized abdominal aorta is normal in caliber throughout its length. the maximum measured diameter is 1.6 cm. bilateral pleural effusions are noted, as seen on the recent ct chest. the right kidney measures 10.1 cm, the left kidney measures 10 cm. the right kidney in particular demonstrates a somewhat echogenic cortex, however, no focal lesions are seen. no hydronephrosis. impression: 1. the aorta is normal in caliber. 2. bilateral pleural effusions. 3. echogenic renal corex suggestive of medical renal disease . discharge labs: 07:10am blood wbc-11.4* rbc-3.02* hgb-9.2* hct-27.0* mcv-90 mch-30.5 mchc-34.0 rdw-15.3 plt ct-167 01:40pm blood hct-29.6*# 08:15am blood neuts-82.5* lymphs-12.2* monos-4.7 eos-0.4 baso-0.2 07:10am blood plt ct-167 07:10am blood pt-14.8* ptt-28.2 inr(pt)-1.3* 08:15am blood plt ct-155 08:15am blood pt-14.9* ptt-27.5 inr(pt)-1.3* 07:10am blood glucose-84 urean-22* creat-1.1 na-139 k-3.7 cl-112* hco3-19* angap-12 08:15am blood glucose-100 urean-30* creat-1.1 na-140 k-3.9 cl-111* hco3-19* angap-14 07:10am blood alt-13 ast-47* alkphos-1508* totbili-0.4 07:10am blood calcium-8.0* phos-2.7 mg-2.2 brief hospital course: assessment and plan: this is a 75 year old male with pmh of diffusely metastatic prostate cancer s/p orchiectomy and his 5th cycle of taxotere chemotherapy/neulasta in , diabetes, and h/o mssa bacteremia s/p antibiotic treatment in presenting with 1 episode of black stools this am, hct drop from 25.7 to 19.6, and a small amount of dark emesis this am s/p an egd on admission which revealed multiple gastric ulcers. . #. ugib. the patient had one episode of dark emesis and dark liquid stools. he had an egd on admission revealing multiple gastric ulcers with one visible vessel that was clipped. there was no active bleeding and the patient received 3 unit of prbcs with appropriate rise in his hct. he was started on protonix gtt which was transitioned to pantoprazole iv bid. aspirin and nsaids were discontinued on admission while beta blocker was held in the setting of upper gi bleed. pt's hct was monitored and stablized. pt was continued on iv ppi and then switched to po ppi prior to discharge (to be continued as outpt) w/gi follow-up in 6-8wks for repeat egd. pt will need to have h pylori serologies followed up as these are still pending. pt's diet was advanced and he was able to be d/c'ed home. . #. pulsatile abdominal mass and bruit. likely consistent with a aaa. low likelihood that the patient has an aortoenteric fistula given that he is hd stable and has multiple gi ulcers that are the likely culprit for his gi bleeding. us of the abdomen was order for futher workup; this showed that caliber of aorta was w/in normal limits. . #. metastatic prostate cancer. defer further management to the outpatient setting and his primary oncologists dr. and . continued on zofran/compazine prn nausea . # svt with ? rate related st changes: hcp/son reports history of svt during his admission in . wife also acknowledges hx of svt in past. during initial episode patient was sleeping and aysmptomatic. resolved with carotid massage. pt had several repeat episodes of svt. metoprolol was restarted and increased to 12.5mg tid from 12.5mg (equivalent to home dose of metoprolol succinat 25mg daily). pt's svt spontaneously resolved or resolved w/carotid massage and pt remained asymptomatic. . #. communication: patient and (hcp/son) (cell), (home), (2nd cell) . outpt follow-up arranged w/pt's oncologist and gi. pt will need to have h pylori serologies followed up as these are still pending. medications on admission: -naproxen 250 mg by mouth twice a day -ondansetron 8 mg by mouth three times a day as needed for nausea -oxycodone 5 mg by mouth every 4 hours as needed for moderate pain -prochlorperazine maleate 10 mg by mouth four times a day as needed for nausea -racecadotril 100 mg daily prn diarrhea -acetaminophen -ascorbic acid -aspirin 81 mg by mouth daily -vitamin b complex -docusate sodium 100 mg by mouth twice a day -folic acid -metoprolol succinate 25mg daily discharge medications: 1. 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* 2. ondansetron 8 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po three times a day as needed for nausea. 3. prochlorperazine maleate 10 mg tablet sig: one (1) tablet po four times a day as needed for nausea. 4. oxycodone 5 mg tablet sig: one (1) tablet po four times a day as needed for pain. 5. racecadotril sig: 100mg once a day as needed for diarrhea. 6. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain: do not take more than a total of 4g of tylenol per day. 7. ascorbic acid 500 mg tablet sig: one (1) tablet po bid (2 times a day). 8. b complex vitamins capsule sig: one (1) cap po daily (daily). 9. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 10. docusate sodium 100 mg capsule sig: one (1) capsule po twice a day: do not take if you are having diarrhea/loose stool. 11. metoprolol succinate 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. discharge disposition: home with service facility: homecare discharge diagnosis: primary diagnosis 1. nsaid induced gastritis and ulcer disease 2. prostate cancer (metastatic) discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you were admitted because you were noted to have dark bowel movements indicating blood in your stool and dizziness with standing as well as some blood in your vomit. you were found to have a low blood volume for which you were given three units of packed red blood cells. . gastroenterology performed an esophagealgastroduodenoscopy which showed several ulcers seen in your gut but no active source of bleeding. one clip was placed on one of the ulcers. your aspirin and all other nsaids (e.g., ibuprofen, naproxen, etc.) were stopped as these likely contributed to the development of the ulcers. you will need to have a repeat endoscopy in 6 to 8 weeks with the gi doctors (see below for appointment details). . you also had an ultrasound of your abdomen which showed that your aorta had a normal diameter. bilateral pleural effusions were noted which have previously been seen on ct scan. echogenic renal corex was suggestive of medical renal disease. you kidney function in the hospital remained stable. . you also had several episodes of fast heart rate but did not experience any symptoms. for this we gave you metoprolol; please continue to take metoprolol at home. . the following changes were made to your medications: - please start taking omeprazole twice daily. - please stop taking aspirin and all other nsaids (e.g. iburprofen, (advil), naproxin (alleve)). - please stop taking naproxen (alleve) - for pain you can take tylenol but do not take more than 4mg of tylenol per day; if your pain is still not controlled, you can take oxycodone - please continue to take all of your other home medications as prescribed. . please be sure to keep all follow-up appointments with your pcp oncologist, gastroenterologist and other healthcare providers. . it was a pleasure taking care of you and we wish you a speedy recovery. followup instructions: please be sure to keep all follow-up appointments with your pcp oncologist, gastroenterologist and other healthcare providers. . you will need to have a repeat endoscopy in 6 to 8 weeks with the gi doctors (see below for appointment details). . department: hematology/oncology when: thursday at 2:00 pm with: , md building: sc clinical ctr campus: east best parking: garage . department: hematology/oncology when: thursday at 2:00 pm with: , md building: sc clinical ctr campus: east best parking: garage . department: hematology/oncology when: thursday at 3:00 pm with: , rn building: campus: east best parking: garage . name: , md specialty: gastroenterology location: -division of gastroenterology/gi west address: , ste 8e, , phone: when: please call office to book a repeat endoscopy procedure with dr in weeks. md procedure: endoscopic control of gastric or duodenal bleeding diagnoses: mitral valve disorders diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled personal history of malignant neoplasm of prostate other and unspecified hyperlipidemia other specified cardiac dysrhythmias chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction secondary malignant neoplasm of bone and bone marrow other specified gastritis, without mention of hemorrhage unspecified analgesic and antipyretic causing adverse effects in therapeutic use body mass index less than 19, adult 

Answer: The patient is high likely exposed to