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: gi bleed major surgical or invasive procedure: egd central line placement history of present illness: pt is an 82 yo male with history of duodenal ulcer s/p surgical bleeding ulcer ligation who was admitted presenting with 1 day of weakness with 3 syncopal episodes at home with loc and fall. on admit, he was found to have a hct 11.8 and 1l blood aspirated by ngt. he was subsequently transfused 8 units of blood to bring his hct to the current level of 33.6 and 6 units platelets in the icu. pt was also given vitamin k. egd was performed and the ulcer was found not to be bleading anymore. site was injected at base with epinephrine and no active bleeding was confirmed by endoscopy. pt has had a stable hct all day and is being transferred to the floor. past medical history: 1. exploratory laparotomy. 2. duodenal gastrotomy with ulcer hemostasis and sutures and duodenal gastrotomy closure on . 3. squamous cell cancer. 4. hypertension. 5. pericarditis. 6. anemia. 7. nephrolithiasis. 8. slipped vertebral disk with surgery social history: retired lawyer, no etoh,tob, ivdu family history: nc physical exam: vs: 98.5 104/50 83 20 98% on 4l gen: nad, laying in bed neck: supple, no lad cv: rrr, s1,s2, no r/g/m lungs: ctab abd: nl bs, obese, soft, nt/nd ext: pulses in all 4 extremities neuro: cn ii-xii grossly intact, pt diffusely weak in upper and lower extremities, pt left eyelid tends to be in ptosis however cn exam seems intact when peruposefully performed. pertinent results: portable cxr findings: cardiac and mediastinal contours are within normal limits for technique. previously seen left pleural effusion is no longer present. however, atelectatic changes are seen at the left lung base. the extreme right costophrenic angle is excluded from the study. the remainder of the lung fields appears clear. pulmonary vasculature is normal. a right subclavian central venous catheter is present with its tip in the distal svc. there is no pneumothorax. the previously seen left subclavian central venous catheter has been removed. impression: left lower lobe atelectasis. no pneumothorax. subclavian central venous catheter with its tip in the distal svc. 04:50pm wbc-17.3*# rbc-1.27*# hgb-3.9*# hct-11.8*# mcv-93 mch-30.7 mchc-33.0 rdw-16.9* 04:50pm plt count-366 04:50pm pt-14.4* ptt-19.3* inr(pt)-1.4 04:50pm fibrinoge-384 04:50pm haptoglob-246* 04:50pm ck(cpk)-90 tot bili-0.1 09:20pm glucose-144* urea n-45* creat-1.0 sodium-142 potassium-4.9 chloride-115* total co2-20* anion gap-12 ecg: baseline artifact. probable sinus rhythm and atrial premature complexes but baseline artifact makes assessment difficult. diffuse nonspecific st-t wave abnormalities - cannot exclude in part ischemia - clinical correlation is suggested. since previous tracing of , modest sinus tachycardia, atrial ectopy and further st-t wave changes present intervals axes rate pr qrs qt/qtc p qrs t 95 136 78 6 31 brief hospital course: pt is an 83yo m with hx of ugi bleed being transferred from the icu for gi bleed stable s/p transfusion of 8u prbc and egd confirmation of no active bleeding from ulcer. . 1. gi bleed: pt presented with hct=11% and urgently transfused 2u prbc. he was transferred to the icu and further transfused 6 more units prbc (to make a total of 8u) and given 6u platelets to correct dilutional thrombocytopenia and vitamin k. pt had egd performed demonstrating clotted blood over ulcer but no active bleed. currently, hct is being maintained > 30%. the patient was placed on iv protonix changed to po protonix . he was advised to not take any more nsaids or aspirin. pt had q8hr hct checked which were stable during stay. telemetry monitoring also showed stable heart rate throughout visit. pt was advanced to regular diet with sucralfate 30 minutes before meals. he was advised never to take ibuprofen, aspirin, alieve or any other nsaid in the future. 2. hypertension: the home beta blocker was initially held as it can blunt response. he was restarted on home meds at discharge. . 3. leukocyteosis: be due to stress on the body but should rule out sources of infection. ua was negative. the patient was given an incentive spirometry for atelectrasis. his foley and central line were discontinued as soon as possible. . 4. std in lateral leads: pt had st depression on initial ekg. this was likely due to stress on cardiac muscle from very low hct. std resolved on repeat ekg. he ruled out for mi. . 5. conditioning: pt seemed diffusely weak. pt was consulted and thought the patient was safe for discharge home with services. medications on admission: asa 81mg qd lipitor 40mg fosamax vit d avapro 150mg qd po calcium discharge medications: 1. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 2. sucralfate 1 g tablet sig: one (1) tablet po qidachs (4 times a day (before meals and at bedtime)). disp:*120 tablet(s)* refills:*2* 3. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 4. avapro 150 mg tablet sig: one (1) tablet po once a day. discharge disposition: home with service facility: homecare discharge diagnosis: primary: duodenal ulcer anemia secondary: hypertension discharge condition: good discharge instructions: please continue your home medications. please call your doctor if you have shortness of breath, dizzyness, black or bloody stools, or loss of consciousness. you must never take motrin, ibuprofen, naproxen, alieve, aspirin, or any other nsaid until you check with your doctor. followup instructions: you should follow the directions listed above in dischare instructions the night before to prepare for your colonoscopy and not eat anything after midnight. please call dr. at with any questions. please arrive at 9am for your 10am appointment with gi. provider: west,room one gi rooms date/time: 10:00 provider: , md phone: date/time: 10:00 procedure: endoscopic control of gastric or duodenal bleeding transfusion of packed cells transfusion of platelets diagnoses: unspecified essential hypertension acute posthemorrhagic anemia pulmonary collapse chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction acute duodenal ulcer with hemorrhage, without mention of obstruction 

Answer: The patient is high likely exposed to