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: no known allergies / adverse drug reactions attending: chief complaint: chest pain, dyspnea on exertion major surgical or invasive procedure: chest tube placement history of present illness: 79 yo w/gist, diastolic chf, afib presents with dyspnea on exertion and chest pain. pt reports sx began 7-10 days ago. exertional only, resolved with rest. also with lh upon standing. no rectal bleeding, no hematemesis or hematuria. last bm yesterday. in ed found to have drop in hct from 32 to 22. ecg without st changes. vitals: 97.5 130/67 79 18 90% on arrival to floor pt reports feeling better after blood transfusion. denies cp, sob, abd pain. 10 point ros: otherwise negative . past medical history: - right medial thigh wound: developed after developing severe cellulitis in late and underwent a biopsy of the area . did not heal due to dm and chemo. sunitinib put on hold to allow further healing, but has since restarted low dose. measurement of wound was 8 x 0.5cm. the first 4 cm on the right was still open with hypergranulation tissue present on . - gist: diagnosed in , treated with surgery and multiple intermittant courses of gleevac, complicated by side effects. she had partial gastrectomy and gist resection in , and a gist omental metastasis resection in 03/. noted to have gib in and due to enlarging gist lesions. started on sutent since . currently on low dose sutent following poor wound healing as above. - anemia, iron deficiency - paroxysmal atrial fibrillation, not on ac due to multiple rp bleeds - congestive heart failure, diastolic, ef >70%. - diabetes mellitus - chronic dyspnea, exertional - hypertension - hypothyroidism - cva in , residual r hemiparesis and intermittent aphasia, - tia in - status post knee surgery in . social history: lives alone. has 2 daughters. moved from in . has grandchildren who visit her. -tobacco history: negative -etoh: negative -illicit drugs: negative family history: no family history of cancer, lung disease or heart disease. + for dm. physical exam: admission exam: vs: 97.4 154/91 70 28 98% on 2.5l gen: nad heent: op clear chest: wheezing in rue, distant breath sounds cv: irreg, irreg, normal rate, no m/r/g abd: distended, soft, nabs, nt/nd ext: no e/c/c neuro: alert, follows commands . discharge exam -patient passed away, dr. pronounced patient pertinent results: 11:00am wbc-7.1 rbc-2.33*# hgb-6.2*# hct-22.0*# mcv-95# mch-26.6* mchc-28.1* rdw-22.6* 11:00am plt smr-normal plt count-391# 12:57pm pt-12.2 ptt-29.1 inr(pt)-1.1 11:00am ctropnt-<0.01 11:00am glucose-109* urea n-32* creat-1.5* sodium-141 potassium-4.7 chloride-103 total co2-27 anion gap-16 11:00am calcium-8.9 phosphate-3.9 magnesium-2.5 cxr (pa/lat) impression: increased opacity at the right lung base, likely a combination of effusion and atelectasis, though underlying pneumonia difficult to exclude. . cxr (portable) impression: ap chest compared to : there is greater consolidation at the right lung base today, which could be atelectasis worsening in the setting of persistent moderate right pleural effusion or worsening pneumonia. improvement in perihilar opacification in the left mid lung may be a function of difference in radiographic technique. the area is not clear, whether it is edema or a second focus of pneumonia, is radiographically indeterminate. moderate enlargement of the cardiac silhouette is longstanding. . ct abd/pelvis (with contrast) impression: 1. large-volume hemoperitoneum concerning for bleeding from diffuse peritoneal metastases, though there is no active extravasation. . 2. increased right pleural effusion with possibly hemorrhagic contents, raising the question of thoracoabdominal communication through a diaphragmatic rent. . 3. volume overload. . ct abd/pelvis (non-contrast) impression: 1. mild interval increase in the complex abdominal fluid, likely hemoperitoneum, compared to . multiple stable peritoneal and mesenteric metastasis. . 2. mild interval increase in the hemorrhagic moderate-to-large right pleural effusion. . ct abd/pelvis (non-contrast) impression: 1. stable intra-abdominal and pelvic hemoperitoneum, overall unchanged since ct from 9 hours prior. 2. foci of hyperdensity within the anterior aspect of the left side of the hemoperitoneum may represent residual contrast within bowel. overall, no significant change in attenuation of the hemoperitoneum to suggest accumulating acute blood product. 3. stable moderate right basilar high density pleural effusion and basilar atelectasis. 4. completely decompressed urinary bladder with foley catheter in place and no residual urine noted within the bladder. large amount of pelvic hemoperitoneum overlies the urinary bladder superiorly. no evidence of hydronephrosis. on review of the prior ct, no distended bladder is identified - it is possible that the post void residual seen was due to above loculated hemoperitoneum given the extent of fluid as described. . ct chest (non-contrast) impression: 1. complete drainage of right pleural fluid collection after placement of right basal pleural catheter. bibasilar opacities are more likely atelectasis than aspiration. status of the effusion can be monitored with serial radiographs if clinically relevant. . 2. intervally enlarged epicardial lymph node with possibly enlarging right hilar lymph nodes are not fully assessed on this non-contrast study. these findings should be reassessed in weeks (or per continuing surveillance plans for intraabdominal malignancy) with a contrast ct study. . 3. complex ascites and other findings of known intra-abdominal malignancy are incompletely assessed on this study. . . ct ap impression: 1. mild interval increase in high density ascites along the left paracolic gutter, representing mild progression of hemoperitoneum compared to . 2. interval drainage of right pleural effusion with pleural catheter in place and hydropneumothorax. 3. redemonstration of the diffuse omental and peritoneal metastases. 4. no evidence of renal vein compression in particular (as queried) given the limitations of this non-contrast study. . brief hospital course: 79 yo w/gist, diastolic chf, afib presents with dyspnea on exertion and chest pain, found to have dropping hgb likely source was hemoperitoneum and hemothorax . # symptomatic acute blood loss anemia: gist tumor bleeding pt received a total of 3 units prbc with improvement in her symptoms. ct abd/pelvis to look for recurrent rp bleed, was delayed due to as the study required contrast. on hosptial day 3 pt had ct scan which showed hemoperitoneum without any active bleeding. she initially remained stable, however, her hct after a period of stability, began to downtrend again, suggesting recurrent bleed. she received 2 additional units of prbc's, with appropriate response. repeat non-contrast ct's showed relatively stable hemoperitoneum, but did suggest expanding pleural effusion, suggesting potential blood loss into the thorax. she underwent chest tube placement by ip at the bedside (see below). she was also seen by surgery consult for possible surgical intervention, however, given the metastatic disease, she is a poor surgical candidate. furthermore, pt and her family did not want to pursue surgery as an option. her case was discussed with ir and they could not see a localized source of bleeding on the ct scans and suggested a tagged rbc scan to further eval for bleeding. however, b/c of , even if a tagged rbc scan could localize bleeding, angiography and intervention would come at high risk for worsening given contrast load and risk of contrast-induced nephropathy. as such, given that pt was clinically stable after the 2nd transfusion, held off a tagged rbc scan. . # gist tumor: was potentially a risk factor for her bleeding, as such, sorafenib was held. this was d/w her primary oncologist, dr. . of note, pt was found to have her brought to the hospital her own pill bottles from home of sorafenib, and had to be instructed multiple times not to take her own pills. her care was further d/w dr. , and there are no chemo options at this time that will provided acute resolution of her bleed. in terms of long term management of her gist, there were still some potential options for chemotherapy, but after a goals of care discussion was had, the patient was made cmo. . # distolic heart failure: home lasix was held on admission due to . pt then developed volume overload with hydration. iv lasix was started and a foley was placed. she initially responded well with good uop and improvement in her cr and respiratory status, suggesting successful diuresis. however, her hct then dropped and she developed , her diuresis had to be stopped. her medications were then discontinued when the family decided to shift the concentration of the patients care towards comfort. . # worsening pleural effusion initially felt to be possibly due to , she was diuresed, with improvement in her respiratory status. ct scan however, showed significantly larger right-sided pleural effusion. ip was consulted for a thoracentesis and a chest tube was placed, which drained significantly bloody effusion. the effusion was consistent with exudative effusion and hemothorax, as it had a hct of 39. the pt continued to have bloody drainage, suggesting possible connection between the abdominal cavity and hemoperitoneum with the thoracic cavity and pleural space. . # acute kidney injury / acute renal failure presented with with elevated creatinine to 1.6 (baseline 1) in the setting of anemia. improved after transfusion of prbc's as well as iv diuresis for presumed volume overload with acute on chronic . then recurred, in the setting of intravascular volume depletion with acute blood loss anemia and aggressive iv diuresis. urine lytes c/w pre-renal etiology, foley catheter placement and abdominal imaging ruled out post-renal obstruction. was seen by renal consult service due to oliguria, sediment showed non-specific granular casts, but no overt evidence of atn. urine with only rare urine eos. creatinine and uop improved with additional prbc transfusion. . # icu course: patient transferred to icu on due to concern for hemoperitoneum, oliguric renal failure, and compartment syndrome. per daughter/hcp, do not want to proceed with surgery and paracentesis not an option given increased risk of bleeding. ct abdomen was obtained which showed mild interval increase of bleeding in the peritoneum cavity and diffuse omental and peritoneal metastases. there was no evidence of renal vein compression, but image was limited as it was non-contrast. her hematocrit came down to 23 and she was transfused 1 unit of prbc on with appropriate bump in hematocrit to 26.1 post-transfusion. her urine output decreased and was bolused with 500cc but without much response. her urine output continues to be 10-20 cc/hr. patient had a period of resp distress with spo2 in low 80s and appeared cyanotic, but improved with sitting up on chair and morphine. a family meeting with (hcp/daughter), icu team, palliative care, and social work occurred on with decision to move to comfort care. patient was also placed dnr/dni. her insulin sliding scale and ceftriaxone were discontinued. she was started on dilaudid iv 0.3-0.6mg q1h:prn for shortness of breath and pain. the palliative care team followed the patient when transfered to the floor. her symptoms were agressviely managed and support was offered to the family. the patient passed away comfortably on . medications on admission: preadmission medications listed are correct and complete. information was obtained from patientwebomr. 1. ammonium lactate *nf* 12 % topical daily 2. clotrimazole-betamethasone *nf* 1-0.05 % topical 3. diltiazem extended-release 180 mg po daily 4. furosemide 60 mg po daily 5. levothyroxine sodium 200 mcg po daily 6. lorazepam 0.5-1 mg po hs:prn insomnia/muscle aches 7. oxycodone (immediate release) 5 mg po q4h:prn pain 8. januvia *nf* (sitagliptin) 100 mg oral daily 9. sorafenib 400 mg po bid 10. timolol maleate 0.5% 1 drop both eyes 11. zolpidem tartrate 10 mg po hs:prn insmonia 12. acetaminophen 325-650 mg po q8h:prn pain 13. aspirin 81 mg po daily 14. camphor-menthol *nf* 230-70 mg topical qid prn itching 15. diphenhydramine-zinc acetate *nf* 2-0.1 % topical qid prn itching 16. docusate sodium 100 mg po bid 17. senna 1 tab po bid:prn constipation 18. urea *nf* 10 % topical qid hands and feet discharge medications: none-patient passed away discharge disposition: expired discharge diagnosis: acute blood loss anemia bleeding gist tumor acute on chronic diastolic heart failure pleural effusion . patient passed away discharge condition: patient passed away discharge instructions: patient passed away followup instructions: patient passed away procedure: insertion of intercostal catheter for drainage diagnoses: unspecified pleural effusion congestive heart failure, unspecified acute posthemorrhagic anemia acute kidney failure, unspecified hyposmolality and/or hyponatremia unspecified acquired hypothyroidism atrial fibrillation acute on chronic diastolic heart failure personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits encounter for palliative care do not resuscitate status delirium due to conditions classified elsewhere hemoperitoneum (nontraumatic) secondary malignant neoplasm of retroperitoneum and peritoneum benign essential hypertension unspecified pruritic disorder other specified forms of effusion, except tuberculous malignant neoplasm of connective and other soft tissue of abdomen 

Answer: The patient is high likely exposed to