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: azithromycin attending: chief complaint: gi bleeding major surgical or invasive procedure: egd history of present illness: 55yof with h/o throat ca in remission who presented to ed with syncope, hematemesis, and black stools and admitted to micu for further management. . she is a somewhat tangential historian but reports not feeling well for the past week with headaches and feeling tired. also with nausea and gerd for the past week. today, she went to nap with her granddaughter and woke up not feeling well; she put the kid in a crib then went to lay down on the cough; unclear what exactly happened but she "fell onto the couch" and when she woke up was covered with dark brownish red blood from her mouth/nose and covering her chest. she likely had loc. she then went to the toilet and had a bm of "black stuff." she denies and bright red blood from above or below. she denies any nsaids, etoh, not on anticoagulation, asa, plavix. . she was not having any abdominal pain until about an hour before admission to micu when she reported llq pain for for the past week, but it appears in atrius records this pain has been going on for at least half a year, see below. she told her pcp about the pain, who ordered a colonoscopy but she didn't have it yet. . she went to hospital where vitals there sbp 110 and p96 with hct 28. she was given 80 mg protonix, 1.5l ns, and ngt placed. tranfer to . . in the ed, initial vs's: 97.4 86 104/69 16 100%ra. orthostatics: 102/60 p100 lying down, and 110/65 p115 sitting up. hct was 25.7 she was noted to look pale and unwell, with ng tube in place, abdomen benign without any tenderness. rectal exam with guaic positive black stool, no blood, no bleeding hemorrhoids. she was started on protonix gtt, 2 piv's were placed, type and screened, blood was ordered. was given another 1l ns in ed (total 2.5l by transfer). blood hanging by the time of transfer. . gi was consulted and recommended ng lavage to see if any bright red blood, in which case plan was to scope tonight; otherwise in the am. she was ng lavaged with 300 cc's of coffee grounds then bilious fluid, no brb. . ekg showed new twi inferolaterally, new from ekg in atrius records. . of note atrius notes indicate pt has llq pain off/on for the past yr and was seen in pcp office in for this. notices the pain more while at work (pushing/pulling, standing all day). last a few days, better with rest. also c/o left lbp with h/o bulging disk. md at that time thought possible l sciatica contributing to llq pain, recommended conservative management, fiber and fluids for ? constipation; she was also reminded that she was overdue for colonoscopy at that time. she had normal lumbar plain film at that time. . vitals before transfer: 98 p90 112/66 18 100% 2lnc. . ros as above, also with chest pain on exertion, relieved with rest for a few years, last stress test years ago. past medical history: - t1, n2b squamous cell carcinoma of the left tonsil, which was moderately differentiated, s/p left modified radical neck dissection and diagnostic tonsillar biopsy on . had positive ln's, s/p radiation therapy that ended in 4/. f/u ct scan without evidence of recurrence, unclear when -- followed by dr. - left mandibular pain after radiation - mitral valve prolapse - h/o thyroid nodule - h/o positive ppd - biapical nonspecific pulmonary nodules less than 5 mm in size noted on surveillance ct, stable per last ent note - uterine fibroids - lgsil on pap smears - h/o hematuria - depression social history: no etoh, but prior heavy use. 1ppd x35 yrs, but quit in . no smoking - quit with throat ca diagnosis, no motrin. no drugs. lives with son. family history: m -- alive, cva's f -- alive, cva's in 80's physical exam: on admission 98.2 p83 107/70 (107-129) 15 100%ra thin, tangential somewhat redirectable f in no distress, conversant eomi, no scleral icterus, conjunctivae not pale mmm, normal appearing. ngt in place, draining light pinkish fluid ctab except light l base crackles rrr without m/g abd soft nt nd, benign no ble edema. extrems are warm cn 2-12 intact, no focal neuro deficits, moving all 4 extremities pertinent results: admission labs: 139 107 41 -----------------< 80 4.0 23 0.6 . ck 55 mb 2 trop <0.01 ca 7.7 mg 1.6 phos 2.2 alt 12 ast 20 alkp 39 tbili 0.3 alb 3.6 wbc 15.3 n93 l4 o/w normal hct 25.7 mcv 90 plts 215 coags 12.9 / 22.0 / 1.1 . ekg: : nsr, normal axis, normal ekg : nsr with normal intevals, twf in v2 is new, inverted t's in v3-6 are new, and twi in all inferior leads are new. pr prolongation. . imaging: none brief hospital course: 55yof with h/o throat ca in remission who was admitted to micu green with ? syncopal episode in the setting of hematemesis and later with melena. 1. acute blood loss anemia, gi bleed: pt presented with 1wk h/o nausea and gerd, possibly consistent with pud. we did not suspect llq pain was relevant, given that these symptoms had been present for 6 mos to 1 yr. she received supportive care for gi bleed including piv x3, octreotide gtt, ivf's, 2u prbc's and had egd the day after admission which showed duodenitis in the proximal duodenum and small ulcer at ge junction. of note the pt became oversedated and had an apneic episode at the end of the egd which was likely due to the fentanyl/versed; she received narcan and flumazenil, was bag-masked, and did not need to be intubated although a respiratory code had been called. she had no further respiratory issues thereafter. she continued to have lowish blood pressures and melena and received further ivf's. she was monitored with serial hct's and eventually switched from ppi gtt to iv bid. she was called out to the floor. her bp and hct remained stable overnight and she was switched to an oral highdose ppi. she was discharged home in stable condition. 2. chest pain: she reported anginal history with occasional chest pain worsened while she was at work, and relieved with rest. she has not had a stress test in "a long time." her ekg's showed inverted tw in v3-6 and inferior leads -- all new since last ekg in . her cardiac enzymes were negative x2. through her course, her ekg's had normalization of tw's laterally. ------ transitional issues: - patient may benefit from outpatient stress test medications on admission: - ranitidine 150 mg - fluticasone 50 mcg nasal spray each nostril daily discharge medications: 1. fluticasone 50 mcg/actuation spray, suspension sig: two (2) spray nasal daily (daily). 2. omeprazole 20 mg capsule, delayed release(e.c.) sig: two (2) capsule, delayed release(e.c.) po once a day: take 30 min prior to eating. disp:*60 capsule, delayed release(e.c.)(s)* refills:*2* discharge disposition: home discharge diagnosis: gi bleed secondary to duodenitis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to for a gi bleed. an edoscopy of your stomach showed evidence of an ulcer. you were transfused several units of blood and your bleeding was stabilized. . while you were here we made the following changes to your medications: we stopped your zantac we started you on omeprazole followup instructions: please call your pcp . at tomorrow to schedule a follow up appointment and to discuss the results of your h pylori testing. procedure: other endoscopy of small intestine diagnoses: mitral valve disorders acute posthemorrhagic anemia diaphragmatic hernia without mention of obstruction or gangrene other specified cardiac dysrhythmias chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction intramural leiomyoma of uterus duodenitis, with hemorrhage personal history of malignant neoplasm of other and unspecified oral cavity and pharynx 

Answer: The patient is high likely exposed to