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: aleve / hayfever attending: chief complaint: lightheadedness major surgical or invasive procedure: esophagogastroduodenoscopy (egd) history of present illness: ms. is a 73 yo f with hx of recurrent gastric cancer with recently seen oozing on upper endoscopy (see egd report/images ), who presents with 4 days of sob and lightheadedness. she was feeling fairly well, with intermittent fatigue, shortness of breath, which became progressively worse 4 days ago. since about a month ago, she has been having intermittent lightheadedness, weakness and increased shortness of breath. in the last week, she has only been able to walk a few steps before becoming short of breath. she had her blood pressure checked at a local pharmacy and found it to be 90/50, which prompted and appointment with her outpatient provider. denies any black stools, bloody stools, or hematemsis. she was seen as an outpatient today. at that appointment, per omr, she was noted to have an irregular rhythm thought to be afib with no ischemic changes. she was referred to the ed for further evaluation. she says that she has otherwise been feeling well recently, and denies fevers, nausea, vomiting, abdominal pain, or diarrhea. she also denies any chest pain. she says she has a large appetite, but can only eat small meals. in the ed, initial vs were: 99.0 103 139/59 20 100%. on exam she was noted to have brown stool, guaiac positive, no melena. pt awake, alert, hemodynamically stable. labs notable for hct 15.1 from 36. wbc 3.1 with 73% pmn's and no bands. no coags sent yet. ecg shows sinus rate 99 nani, no st changes. cxr showed no acute process per prelim read. gi consulted from the ed, and think likely slow bleed with plan to scope in the am. she was given protonix 40mg iv x1. she was also given 500cc ns of the 1l ordered. she has not received blood yet but 2 units ordered, but have not yet arrived. for access she has 2 piv's 18g and 20g. vs prior to transfer 120/64 91 18 100% 3lnc (likely does not require 3l but felt sob). on arrival to the micu, her vs are t 98.2 bp 132/67 hr 99 rr 13 o2 sat 100%. she says she feels well now, but will become short of breath or lightheaded with any movement. she says that since the diagnosis of her recent gastric carcinoma, she has been in discussion with dr. and her previous surgeons dr. . per the pt, a meeting was held, and dr. thinks repeat surgery would be risky. she is scheduled to have a second opinion with dr. at . she says that if surgery is not an option, they are considering further chemoradiation. her last chemotherapy was in . past medical history: gastric adenocarcinoma, signet ring: stage iiib, pt4a pn2 cm0 - dx by ct and egd bx - resection : subtotal gastrectomy + gastrojejunostomy + ccy - path : poorly diff, diffuse infiltrative, >50% signet rings -- visceral peritoneum involved, nodes, lesser omental margin (+) -- lymphatic, venous, and perineural invasion - : day 1 adjuvant chemo; : day 1 rads (50.4 gy) - : all chemorads complete gastritis asthma, allergic/seasonal, mild intermittent htn (distant, none currently) benign cecal polyp s/p l cecectomy (), diverticulosis social history: home: lives alone in adls: fully independent in adls and iadls origin: grew up in ma family: divorced, 3 kids (2 , 1 son) a/w/local, 1 grandchild a/w support: family heavily involved subst: tob: ppd x few years, quit x45 years etoh: quit x3 years, previously "social" ivd: denies family history: (+) for htn, dm2, obesity in mother, brother (+) for mi in father (+) for uc in father, son (+) for prostate and lung cancers in uncles (-) for gastric cancer physical exam: on admission: vitals: t 98.2 bp 132/67 hr 99 rr 13 o2 sat 100% general: alert, oriented, no acute distress, pleasant elderly female heent: sclera anicteric, pale conjunctiva, mildly dry mm, oropharynx clear, eomi neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, lusb without radiation lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: well-healed surgical scars, soft, non-tender, non-distended, bowel sounds present, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: cnii-xii intact, moiving all extremities, no gross deficits on discharge: vital signs: t 98.4 p 72 bp 106/50 rr 16 o2 95 ra general: alert, oriented, no acute distress, pleasant elderly female heent: sclera anicteric, pale conjunctiva, mmm, oropharynx clear, eomi neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, ii/vi systolic murmur at lusb without radiation lungs: clear to auscultation bilaterally, no wheezes, rales, rhonchi abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly; well-healed surgical scars ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: cn ii-xii intact, moving all extremities; no deficitis in coordination/gait pertinent results: admission labs: 04:49pm blood wbc-3.1* rbc-1.99*# hgb-4.4*# hct-15.1*# mcv-76*# mch-21.9*# mchc-28.9*# rdw-18.4* plt ct-479* 04:49pm blood neuts-73.2* bands-0 lymphs-17.4* monos-5.1 eos-3.3 baso-1.1 04:49pm blood hypochr-3+ anisocy-2+ poiklo-2+ macrocy-normal microcy-3+ polychr-normal ovalocy-occasional target-occasional acantho-occasional 04:49pm blood plt smr-high plt ct-479* . 04:49pm caltibc-442 haptoglob-178 ferritin-2.8* trf-340 04:49pm iron-9* . 04:49pm glucose-108* urea n-22* creat-0.9 sodium-139 potassium-3.7 chloride-107 total co2-25 anion gap-11 04:49pm ld(ldh)-121 09:37pm calcium-8.0* phosphate-3.3 magnesium-1.9 09:37pm alt(sgpt)-13 ast(sgot)-19 alk phos-109* tot bili-0.1 . 07:42pm pt-11.5 ptt-25.2 inr(pt)-1.1 09:37pm fibrinoge-256 . 04:04am blood wbc-3.0* rbc-2.98*# hgb-7.9*# hct-23.9*# mcv-80* mch-26.4*# mchc-32.9# rdw-17.4* plt ct-413 10:10am blood hct-28.5* 01:00pm blood hct-26.9* 07:25pm blood hct-25.7* 06:10am blood hct-26.0* imaging: cxr : pa and lateral views of the chest are compared to previous exam from . subtle opacity is noted at the left lung base which may represent atelectasis versus early pneumonia. posterior costophrenic angles are sharp. elsewhere, the lungs are clear noting minimal biapical scarring. the cardiomediastinal silhouette is within normal limits. osseous and soft tissue structures are unremarkable. egd : -esophagus: mucosa: erythema was seen at the ge junction consistent with esophagitis. -stomach: mucosa: erythema and petechia were noted in the funus and cardia of the stomach. there was contact bleeding but no single clear place to intervene upon and the abnormalities were diffuse. the gj anastamosis site was without ulceration or breakdown, although there was some congestion in the area of cancer recurrence. -duodenum: normal duodenum. brief hospital course: 73f with history of recurrent gastric cancer, who presented with fatigue, dyspnea, and lightheadedness in setting of 21 point drop in hct, likely secondary to slow upper gi bleeding in setting of known gastric cancer with egd this admission showing diffuse contact bleeding of gastritis. # iron deficiency anema/upper gi bleeding: patient presented with symptomatic anemia and hct 15.1, with guiac positive stool. her labs were suggestive of iron defiency anemia, with iron level 9 and ferritin 2.8, likely secondary to slow upper gi bleeding in setting of known recurrent gastric cancer. labs were not consistent with dic or hemolysis. she was transfused 3 units prbcs with appropriate rise in hct. gi was consulted, and performed egd on . egd demonstrated esophagitis, as well as erythema and petechiae in stomach with contact bleeding but no single place to intervene upon. the gj anastamosic site was without ulceration or breakdown. she was initially started on an iv ppi , and transitioned to an oral ppi prior to discharge. she was also started on sucralfate and ferrous sulfate supplementation. she remained hemodynamically stable, with stable serial hcts. will follow-up with her pcp and oncology on discharge. she will need hct checked 1-2 times per week, as she is likely to have chronic slow gi bleeding. need additional transfusions in the outpatient setting. next hct check . iron level was 9 and ferritin 2.8. # gastric cancer: stage iiib (pt4a pn2 cm0) signet ring cell gastric adenocarcinoma, s/p subtotal gastrectomy with gastrojejunostomy in , and s/p chemoradiation. patient recently diagnosed with recurrence based on biospy results from egd. she did not have evidence of metastatic disease on recent ct torso/pet ct. is followed closely at by dr. , dr. , and dr. . per reports, felt that additional surgery may be too risky, though patient is seeking second opinion. she will follow-up with her outside providers this week to discuss next steps in her care. transitional issues: -patient's code status was full code this admission -patient will need monitoring of hct 1-2 times per week, as she will likely continue to have slow, ongoing blood loss. need additional tranfusions in outpatient setting. hct was 26.0 on here (day of discharge). medications on admission: meclizine prn omeprazole 40mg b12 1000mcg daily albuterol hfa prn tightness, sob discharge medications: 1. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: one (1) puff inhalation q4h (every 4 hours) as needed for tightness, sob. 2. cyanocobalamin (vitamin b-12) 1,000 mcg tablet sig: one (1) tablet po once a day. 3. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. 4. sucralfate 100 mg/ml suspension sig: one (1) gram po three times a day. disp:*1000 ml* refills:*1* 5. outpatient lab work please check hct . results to dr. . 9/hematology-oncology . phone (. fax (. 6. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*1* discharge disposition: home discharge diagnosis: primary diagnosis: iron deficiency anemia gastrointestinal bleeding esophagitis gastritis secondary diagnoses: gastric cancer, recurrent discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear ms. , you were admitted because you were lightheaded and short of breath. we checked your blood counts, and your red blood cell count was very low. we gave you fluids and several blood transfusions, and your counts came up. we checked your iron levels, and they were also low. we looked at your stomach with an endoscope (esophago-gastro-duodenoscopy, or egd). we found that your esophagus and stomach were inflamed. we gave you medicines to coat your stomach and reduce your stomach acid. these medicines may help reduce the risk of further bleeding, however it is likely that you will continue to have blood loss. you will need to have your blood counts checked fairly frequently after you leave the hospital (1-2 times per week). please take the lab slip we have given you (printed on prescription paper) and go to the lab to have your blood checked on tuesday. please start the following medication: carafate (sucralafate) - 1 gram, three times a day ferrous sulfate (iron) - 325 mg daily iron supplements can lead to constipation, and we would recommend you take an over-the-counter stool softener to help prevent constipation, such as colace (docusate sodium). please stop the following medication: meclizine please continue to take all other medications as previously prescribed. please also follow up with your pcp, . , and other doctors as listed below. followup instructions: please call your primary care doctor's office on monday to schedule a follow-up appointment. the clinic number is . on monday, you should also call the radiation oncology department to schedule an appointment. the number is . please call to confirm your next appointment with dr. and/or dr. . they would like to follow-up with you this week. department: general surgery/ when: thursday at 11:30 am with: , md building: lm bldg () campus: west best parking: garage department: hematology/oncology when: wednesday at 1:30 pm with: , md building: sc clinical ctr campus: east best parking: garage department: hematology/oncology when: wednesday at 1:30 pm with: , md building: sc clinical ctr campus: east best parking: garage procedure: other endoscopy of small intestine diagnoses: iron deficiency anemia secondary to blood loss (chronic) atrial fibrillation personal history of tobacco use unspecified gastritis and gastroduodenitis, with hemorrhage esophagitis, unspecified precipitous drop in hematocrit personal history of antineoplastic chemotherapy personal history of irradiation, presenting hazards to health secondary and unspecified malignant neoplasm of intra-abdominal lymph nodes extrinsic asthma, unspecified malignant neoplasm of pyloric antrum 

Answer: The patient is high likely exposed to