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: lethargy major surgical or invasive procedure: egd colonoscopy history of present illness: mrs. is a very pleasant 86 yo woman with a h/o dvt on oral anticoagulation and moderate dementia who presented to an osh emergency department at the urging of her daughter a complaint of lethargy, weakness and fatigue. her initial vss were 98.1, 92, 112/46, 18, 98% on ra. at the osh, she was noted to have a hct of 17 and an inr of 10. she received 10 mg vit k iv and ffp and was transferred to for further management. . in the ed, her initial vss were 97.6, 86, 116/46, 18, 94% 3lnc. she received 1 unit prbcs. . upon arrival in the , she is unable to give any history. . she denied abdominal pain, shortness of breath, chest pain, diarrhea, hematochezia, hematemesis, melena. past medical history: h/o dvt dementia hypothyroidism htn social history: lives in (unclear with whom). presently visiting daughter for holidays. no smoking, alcohol or drug use. family history: non-contributory physical exam: vitals: t: 99.5 bp: 175/68 p: 128 r: 16 sao2: 100% 2lnc general: awake, alert, nad, pleasant, appropriate, cooperative, a&ox2 heent: ncat, perrl, eomi, conjunctival pallor, no scleral icterus, mmm, no lesions noted in op neck: no significant jvd pulmonary: lungs cta bilaterally, no wheezes, ronchi or rales cardiac: tachycardic, nl s1 s2, ii/vi systolic murmur heard best at lusb, no rubs or gallops appreciated abdomen: soft, nt, nd, normoactive bowel sounds, no masses or organomegaly noted extremities: no edema, 2+ radial, dp pulses b/l pertinent results: ecg study date of 2:11:50 am sinus rhythm probable atrial premature complex left ventricular hypertrophy consider left anterior fascicular block st-t wave abnormalities - could be due to left ventricular hypertrophy but nonspecific no previous tracing available for comparison . egd (): impression: there was no fresh or old blood noted in the stomach or proximal small bowel. otherwise normal egd to second part of the duodenum . colonoscopy (): polyp in the sigmoid colon (biopsy) otherwise normal colonoscopy to cecum . admit labs: ------------ 01:40am blood wbc-11.2* rbc-1.58* hgb-4.9* hct-14.1* mcv-89 mch-31.3 mchc-35.2* rdw-16.3* plt ct-184 01:40am blood neuts-76.6* lymphs-17.7* monos-4.4 eos-1.1 baso-0.2 01:40am blood pt-20.1* ptt-30.3 inr(pt)-1.9* 01:40am blood glucose-106* urean-67* creat-1.3* na-142 k-4.6 cl-109* hco3-23 angap-15 01:40am blood ck(cpk)-58 01:40am blood ck-mb-6 ctropnt-0.03* 05:57pm blood calcium-8.5 phos-3.0 mg-2.1 . other/discharge labs: 01:50pm blood wbc-10.2 rbc-3.71* hgb-11.0* hct-32.4* mcv-87 mch-29.8 mchc-34.1 rdw-16.9* plt ct-249 07:50am blood wbc-7.8 rbc-3.35* hgb-10.1* hct-28.9* mcv-86 mch-30.2 mchc-34.9 rdw-17.1* plt ct-223 10:30am blood wbc-9.0 rbc-3.79* hgb-11.3* hct-32.9* mcv-87 mch-29.9 mchc-34.4 rdw-16.9* plt ct-225 07:25am blood wbc-9.7 rbc-3.97*# hgb-11.8*# hct-34.8*# mcv-88 mch-29.7 mchc-33.8 rdw-17.1* plt ct-232 07:50am blood glucose-98 urean-19 creat-1.0 na-140 k-4.4 cl-111* hco3-24 angap-9 07:25am blood glucose-118* urean-28* creat-1.2* na-149* k-4.3 cl-117* hco3-23 angap-13 03:46am blood ck(cpk)-89 05:57pm blood ck(cpk)-80 03:46am blood ck-mb-5 ctropnt-0.04* 05:57pm blood ck-mb-6 ctropnt-0.04* 01:40am urine color- appear-clear sp -1.012 01:40am urine blood-lg nitrite-neg protein-100 glucose-neg ketone-neg bilirub-neg urobiln-neg ph-6.5 leuks-neg 01:40am urine rbc->50 wbc- bacteri-few yeast-none epi-0-2 renalep-0-2 brief hospital course: 86 yo woman presents with gi bleed in setting of supratherapeutic inr. . ## acute blood loss anemia/gi bleed: given dark stools and dramaticially low hct, likely ugib. denies hematemesis, hematochezia. patient was transfused with improvement in her hct as above. her coumadin was held and her anticoagulation was reversed. she had an egd that was unremarkable. colonoscopy showed a polyp that was sent for biopsy (found to be hyperplastic polyp). no evidence of bleeding seen on egd or colonoscopy. patient was initially in the icu, however was transferred to the floor and remained hemodynamically stable. she was maintained on protonix . given no clear source of bleeding, she will need a small bowel capsule study, which will be arranged by gi as an outpatient. . ## h/o dvt: warfarin held in setting of dramatic anemia. . ## htn: antihypertensives held in the setting of gi bleed. on discharge, blood pressure slightly elevated, so patient instructed to restart diovan. . ## hypothyroidism: continued on levothyroxine. . ## hyperlipidemia: the patient was continued on simvastatin. . ## dispo - the patient was seen by pt, who recommended home pt. the patient went to her daughter's house to stay temporarily since she stays on her own in . her daughter will arrange for a pcp in the area such that she can get home services such as a visiting nurse and home pt. medications on admission: warfarin levothyroxine 50 ezetimibe-simvastatin 10-40 valsartan 320 daily discharge medications: 1. vytorin 10-40 10-40 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 2. valsartan 320 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 3. levothyroxine 50 mcg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 4. protonix 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day: can substitute prilosec 20mg or prilosec otc 20mg if protonix not covered. disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* discharge disposition: home discharge diagnosis: primary: anemia, acute blood loss gi bleed secondary: hypothyroid dementia hypertension recurrent deep venous thromboses discharge condition: afebrile, vital signs stable. ambulating without lightheadedness or dizziness. hct 32. discharge instructions: you had a significant drop in your blood count, likely due to a gastrointestinal bleed. this was likely caused by the coumadin which you were taking. you had an upper endoscopy (egd) and a colonoscopy. these tests did not reveal a source for the bleeding. you will need to have a small bowel capsule study to look for a source of bleeding. you will be contact next week by the gastroenterology team to set up that appointment. until then, you have this study done, you should not take your coumadin. you will need to talk to your primary care doctor about restarting your coumadin. your blood pressure medication (valsartan) was held during this admission. this can be restarted on discharge. you should avoid aspirin and other nsaids (like ibuprofen) since these medications can cause gi bleeding. please keep your self well hydrated by drinking plenty of water. . you were seen by physical therapy and it was recommended that you get home pt. you may also need a visiting nurse. since your primary care doctor is in , this cannot be done in , unless you establish a primary care doctor. you can call one of the numbers below to set up a primary care doctor or you can locate one of your own. alternatively, you can return to and have these services set up over there. . you are being given prescriptions for all of your medications in case you run out before you see your doctor. . please return to the emergency room if you should have blood in your stools or increasingly black stools. you should also return if you feel very dizzy or lightheaded or should have chest pain or shortness of breath. followup instructions: primary care: if you wish to establish primary care at , you can call for the clinic or for the clinic. alternatively, you can follow up with your doctor, dr. in . procedure: other endoscopy of small intestine endoscopic polypectomy of large intestine transfusion of packed cells transfusion of other serum diagnoses: unspecified essential hypertension acute posthemorrhagic anemia unspecified acquired hypothyroidism other persistent mental disorders due to conditions classified elsewhere long-term (current) use of anticoagulants personal history of venous thrombosis and embolism anticoagulants causing adverse effects in therapeutic use hemorrhage of gastrointestinal tract, unspecified benign neoplasm of colon 

Answer: The patient is high likely exposed to