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: hematemesis major surgical or invasive procedure: endoscopy history of present illness: 69 year old who present with hematemesis and abdominal pain. the patient initially woke up about this morning noticing blood in his mouth. he said it was about a very small amount, less than the bottom of a cup. pt denies any vomiting, wretching or melena. because he was notified about his pcp 2 days prior that he had a inr of 7.8 in the context of coumadin for atrial fibriallation, he decided to come into the emergency room. in the emergency room he started to experience sharp epigastric abdominal pain that was gradually worsening. the pain was not radiation and only improved with dilaudid. he denies any similar abdominal pain prior to this episode. . in the ed, the pt was found to have lateral std and was given aspirin and nitroglycerin initially without improvement. an ng lavage found about 200cc of bright red blood in the stomach, which subsequently cleared. he was given a gi cocktail,protonix, morphine and dilaudid for abdominal pain. a ct of the abdomen did not show any poa other then possible blood in his stomach. vit k was given for the reversal of his coumadin. the pt was hemodynamically stable throughout his hospital course. . ros: he denies cp, lightheadedness, dizziness, mouthpain, easy bleeding or easy bruising, dysuria, lle. he reports chronic mild sob, which is uncahnged. he denies f/c/ns, weight loss. he also denies changes in his diet or any intake of nsaids or large amount of alcohol. also, denies any liver problems in the past. past medical history: htn smoking polycythemia osa? osa refractory to cpap hx iron deficiency anemia cri with bl cr 1.3-1.5 htn cad: last cath documenting mild to mod diffuse cad, but no obstructing lesions, mi x 2; ef 50% most recently, 2+ mr, 2+ ar atrial fibrillation on coumadin medullary thyorid ca s/p thyroidectomy parathyroid adenoma s/p partial parathyroidectomy turp bph pud s/p gastrectomy/billroth ii tear in p/w brbpr s/p ccy ventral hernia raynaud's hematuria with hx epidymitis depression social history: lives in jp, divorced from wife , though she still is involved w/ his care, son also suppportive, tobacco *40 pack year hx, stopped 1 month ago, rare eoth, former engineer, came to us from in' . family history: no h/o premature cad, no family hx of medullary thyorid ca physical exam: vitals: t96.1 bp 146/57 hr 56 r 20 94%4lnc gen: sleepy but awakens without difficulty, nad heent: ncat, sclerae anicteric/noninjected, eomi, p constricted but errl, op clear, no evidence of bleeding, uvula midline, dry mm neck: jvp 8 cm, no lad cv: distant heart sounds, nl s1/s2, irregular 21/6 diastolic and systolic non radiating murmur noted over precordium lungs: mild crackles in r base, no wheezes or rhonchi ab: soft, nd, nabs, no hsm by percussion, tenderness in epigastrium, no rebound or guarding extrem: 2+ dp, no c/c/e skin: no rashes neuro: oriented x3, moving all extremitites pertinent results: 09:14pm ck(cpk)-110 09:14pm ck-mb-5 ctropnt-<0.01 09:14pm hct-44.8 09:14pm pt-26.6* ptt-36.8* inr(pt)-2.7* 02:04pm type- comments-green top 02:04pm hgb-16.6 calchct-50 10:20am glucose-95 urea n-26* creat-1.3* sodium-139 potassium-4.4 chloride-104 total co2-25 anion gap-14 10:20am estgfr-using this 10:20am alt(sgpt)-27 ast(sgot)-25 ck(cpk)-122 alk phos-69 amylase-73 tot bili-0.6 10:20am ck-mb-6 ctropnt-<0.01 10:20am wbc-6.4 rbc-5.31 hgb-16.4 hct-47.7 mcv-90 mch-30.9 mchc-34.4 rdw-14.1 10:20am neuts-69.2 lymphs-22.3 monos-4.1 eos-3.0 basos-1.4 10:20am plt count-163 10:20am plt count-163 10:20am pt-52.2* ptt-47.0* inr(pt)-6.2* . brief hospital course: 69yo male with cad, cm with ef 50%, cri, hx billroth ii for pud, polycythemia , afib on coumadin who presents with ugib in the context of elevated inr with stable hematocrit and stable vital signs. brief hospital course by problem below: . gi bleed- egd with multiple new and healed ulcers. ulcers with stigma of new bleeding. pt was started on ppi . he was kept npo overnight. inr was reversed with 2u of ffp preprocedure and 1 additional unit post procedure. he was given vit k 5mg 2x. hct was checked q6h. pt dropped to as low as 42 and never required blood transfusion. hct has been stable for 8h on call out. two large bore ivs were maintained. h.pylori serology was sent and empiric treatment was started. given extend of ulceration and history of pud, nsaids use had to be suspected, however the patient denies. also, given hx of medullary thyroid cancer, and prior hyperparathyroidism, possible men could be considered. medullary cancer would be associated with men ii, hyperparathyroidism with men i which presents which associated zollinger- syndrome. gastrin levels were checked- given gastrin level of 23, ze unlikely. pt had a stable hct on discharge and should follow up with dr. on . . abdominal pain: likely etiology as above. no evidence of liver disease or pancreatitis. no evidence of other intraabdominal pathology on ct. no evidence of free air on cxr. morphine iv prn was given. abdominal pain improved with treatment. . cv:new onset std in v5, v6, concern for ischemia. pt denies any chest pain, suggesting against an acute coronary syndrome. also, hct > 40 therefore unlikely to be demand ischemia. sob could be cp-equivalent, however appears to be chronic. aspirin was held in the context of gib. antihypertensives in the context of gib were held initially, subsequently carvedilol, imdur, and nifedipine were serially restarted. ce's trended-negative. statin started. . chf: echo->ef 50% in . antihypertensives in the context of gib were held initially, subsequently carvedilol and imdur were restarted. . afib: rate controlled with bb; held coumadin initially in the context of gib, restarted at low dose (2.5mg daily- to be followed up with pcp . ; holding bb initially, subsequently restarted. . cri- long standing htn. on baseline. received dye load for ct. ivf with sodium bicarbonate given for post-ct hydration. remained stable. . sob: as above, might be ill-defined symptom of heart disease. no evidence of fluid overload on cxr. does not appear fluid overloaded. resolved to baseline at time of discharge. . medications on admission: calcitriol 0.5 fluoxetine 20 mg synthroid 150 mg qd coreg 3.125 mg asa 325 mg qd protonix 40 mg qd sucralfate 1 mg nfedipine 20 mg qd docusate 100 mg senna vitamin c calcium 600 mg tid ferrous gluconate 325 mg qd lipitor 80 mg qhs imdur 30 mg qhs doxazosin 2 mg coumadin 5d 5mg, 2d 2.5mg clonazepam 1 mg qhs uroxatral 10 mg qhs discharge medications: 1. carvedilol 12.5 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*2* 2. amoxicillin 500 mg capsule sig: two (2) capsule po q12h (every 12 hours) for 11 days. disp:*44 capsule(s)* refills:*0* 3. clarithromycin 250 mg tablet sig: two (2) tablet po q12h (every 12 hours) for 11 days. disp:*44 tablet(s)* refills:*0* 4. sucralfate 1 g tablet sig: one (1) tablet po qid (4 times a day). disp:*120 tablet(s)* refills:*2* 5. isosorbide mononitrate 30 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po daily (daily). disp:*30 tablet sustained release 24hr(s)* refills:*2* 6. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. levothyroxine 50 mcg tablet sig: three (3) tablet po daily (daily). disp:*90 tablet(s)* refills:*2* 8. clonazepam 0.5 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)) as needed for insomnia. disp:*30 tablet(s)* refills:*0* 9. fluoxetine 20 mg capsule sig: one (1) capsule po daily (daily). disp:*30 capsule(s)* refills:*2* 10. 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* 11. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po q4-6h (every 4 to 6 hours) as needed for pain. disp:*30 tablet(s)* refills:*0* 12. warfarin 2.5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 13. calcitriol 0.5 mcg capsule sig: one (1) capsule po twice a day. disp:*60 capsule(s)* refills:*2* 14. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po qid (4 times a day). disp:*120 tablet, chewable(s)* refills:*2* 15. nifedipine 90 mg tablet sustained release sig: one (1) tablet sustained release po once a day. disp:*30 tablet sustained release(s)* refills:*2* discharge disposition: home discharge diagnosis: primary diagnosis: erosive gastritis secondary diagnoses: 1. afib 2. cad 3. hypertension 4. medullary thyroid cancer discharge condition: stable discharge instructions: weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet . please remember to make your follow-up appointments below . return to the ed if you have any of the following: *fever>101 *blood in your stool *dark stool *feeling dizzy or lightheaded *vomiting blood followup instructions: please remember to make the follow-up appointments below . you have an appointment with your pcp . () on at 9:30am. you will need to get your blood checked on any time between 12pm-7pm. it is very important to make this appointment to make sure your blood thinner is working properly. you will need to discuss with your pcp about restarting medication for your prostate gland including doxazosin and uroxatral. . these are your other appointments- provider: , md phone: date/time: 3:30 provider: west,room three gi rooms date/time: 1:30 provider: procedures fellow phone: date/time: 1:30 procedure: endoscopic control of gastric or duodenal bleeding diagnoses: coronary atherosclerosis of native coronary artery hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation chronic kidney disease, unspecified other specified gastritis, with hemorrhage malignant neoplasm of thyroid gland 

Answer: The patient is high likely exposed to