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: ugib major surgical or invasive procedure: endoscopy (egd) angiography with embolization of gda history of present illness: 77 year old man with locally advanced, unresectable pancreatic cancer s/p cyberknife and current rx with gemcitabine here ugib. he had mild abd pain and nausea on sunday and went to the ed. stones noted in gb. then had improvement in sx for a few days. he went to clinic this am for chemo but felt fatigued. pos orthostatics so received ivf. this evening he awoke at 9pm feeling nauseated. he fell and hit his head. subsequently had large bout of hematemesis. called ems and brought to ed. also noted weakness but denied any diarrhea, black/bloody stool. denies recent nsaid use, heavy etoh, steroids, or tobb abuse. egd in showed tumor infiltration seen in the duodenal bulb. . in the ed, initial bp 84/48 w hr 103. received 4l ivf and bp improved to 120s systolic. ngl positive clots then brb which did not clear for >2l. 2 18g and 1 16g placed. hct 31 (down from 40 in am). given protonix 40 iv, 2u prbcs, 3u ffp. . currently, he feels fairly well. mild nausea. no abd pain. no f/c/sob/cp. past medical history: pancreatic cancer - dx : hop mass. cbd obstruction. invasion of celiac axis and near commencemnet of the smv and portal vein. - : ercp w stent to cbd for malignant stricture. cytology c/w adenoca - 10 cycles of gemcitabine. cyberknife rx diabetes htn social history: 100 pack yrs tobb. quit 8 yrs ago. occas etoh. married w 6 children. retired painter at family history: breast ca physical exam: vs: 98.4 82 135/65 95% ra rr17 gen: dry mm. aaox3, appropriate and interactive heent: mm dry. jvp 6cm. ngt w bloody output cards: rrr no mgr resp: slight rales right base. nl effort. otherwise clear abd: no epigastric discomfort. no rebound or guarding. bs+. no tenderness anywhere. no masses. no organomegaly. ext: no edema neuro: aaox3. follows commands. cn ii-xii intact. motor bilat upper/lower. light touch. toes down bilat access: 2 18s and 1 16 rectal: brown ob positive stool pertinent results: ca19- elevated at 1199, up from 475 in .4 3.2 >-----< 117 40.5 ---> 31 gran-ct: 2050 alt: 37 ast: 40 ldh: 170 ap: 104 tbili: 0.5 alb: 3.5 pt: 15.6 ptt: 30.1 inr: 1.4 139 107 18 --------------< 195 4.5 23 0.7 . ekg: nsr na ni, twi avl, biphasic t v2 . ruq u/s: stone-filled gallbladder with a 1.3-cm gallbladder neck stone ill-defined thickened gallbladder unchanged since prior study. differential diagnosis is wide, includes, chronic cholecystitis, radiation changes or neoplastic infiltration. . ct abd: wet read: large stomach with possible partial outlet obstruction. no acute pathology. cxr : ng tube tip is in the stomach. improvement of the interstitial edema. still present left lower lobe opacity, which might be consistent with aspiration. endoscopy (egd): ulcers in the gastroesophageal junction blood in the whole stomach ulcer in the duodenal bulb ulcerated area in the cardia otherwise normal egd to duodenal bulb angiography : tumor encasement of distal common and proper hepatic arteries and proximal middle and right hepatic arteries and gastroduodenal artery. gda is severly stenosed but was successfully coil embolized with no further antegrade flow seen. probable underlying hepatic cirrhosis in this patient with tumor encasement of hepatic and gastroduodenal arteries. no signs of active bleeding on the selective arteriograms of the sma, hepatic, and left gastric arteries. brief hospital course: 77 year old man with locally advanced, unresectable pancreatic cancer s/p cyberknife and current rx with gemcitabine here with ugib. . ugib: initially suspected tumor invasion in duodenum. also be related to the cbd stent placed although less likely with normal lfts and no abd pain. other possibilities included , pud, dieulafoys, varices. pt was given aggressive blood resuscitation, receiving 2 units prbc and 3 units ffp in the ed followed by 4 units prbc on arrival to the icu. pt was started on ppi iv bid. clots were washed out with 3l sterile water nasogastric lavage. pt did well overnight and underwent upper endoscopy in the morning. endoscopy revealed ulcer in the duodenal bulb and ulcerated region in the cardia. endoscopy was complicated by a drop in oxygen saturation secondary to sedation. after the procedure pt returned to baseline o2 saturations. later that day pt underwent angiography which revealed no actively bleeding vessels. it showed tumor encasement of distal common and proper hepatic arteries and proximal middle and right hepatic arteries and gastroduodenal artery. gda was severely stenosed but was successfully coil embolized. pt experienced rebleeding later that night presenting as brbpr requiring an additional 2 units prbcs. patient responded well to the transfusion. gastroenterology, oncology, and radiation oncology were consulted. the decision was made that there are no appropriate interventions at this time. the patient's condition and prognosis was discussed with the patient and his family. the decision was made to become dnr/dni. without any available treatment, the patient decided he would rather go home than continue to be monitored in the hospital. pain/palliative care was consulted and the patient was set up with home hospice. patient was discharged home. wife (hcp) . medications on admission: lisinopril 5 metformin 1000 compazine 10 q4-6h prn asa 81 mvi ranitidine 150 discharge medications: 1. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 2. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain. disp:*60 tablet(s)* refills:*2* 3. zofran odt 4 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po every 4-6 hours as needed for nausea. disp:*10 tablet, rapid dissolve(s)* refills:*2* 4. home oxygen titrate to oxygen saturations in the mid 90s. discharge disposition: home with service facility: health vna discharge diagnosis: primary: upper gastrointestinal bleed secondary to locally invasive pancreatic cancer; anemia secondary to blood loss secondary: type 2 diabetes mellitus discharge condition: stable discharge instructions: you were admitted to the icu after experiencing an episode of upper gi bleeding that was evident by your vomiting a large quantity of blood. after you were admitted we transfused many units of blood until your blood counts were stable and the bleeding had stopped. gastroenterology performed an upper gi scope to confirm your pancreatic cancer as the cause of the bleeding. angiography was performed in an attempt to close off the bleeding vessel. however there was subsequent bleeding after the procedure. oncology, radiation-oncology, and gastroenterology were all consulted. it determined that there is no intervention at this time that would effectively prevent future bleeding. without any possible treatment you decided you would rather return home than continue to be monitored in the hospital. you met with our palliative care team that helped to arrange home hospice care to ease your transition home for you and your family and make you as comfortable as possible. followup instructions: contact oncology to determine if follow up is necessary md procedure: other endoscopy of small intestine arteriography of other intra-abdominal arteries transcatheter embolization for gastric or duodenal bleeding diagnoses: unspecified essential hypertension acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled secondary malignant neoplasm of other specified sites chronic or unspecified gastric ulcer with hemorrhage, without mention of obstruction chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction hemorrhage of gastrointestinal tract, unspecified stricture of artery ulcer of esophagus with bleeding malignant neoplasm of other specified sites of pancreas 

Answer: The patient is high likely exposed to