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: lisinopril / plavix attending: chief complaint: fatigue, anemia major surgical or invasive procedure: endoscopy and biopsy; colonoscopy history of present illness: ms. is a 72 yof with h/o post-op dvt on coumadin and no prior gib, who was referred to the ed by her pcp for two weeks of dizziness and fatigue. she was found to have a hct of 17 with grossly positive guaiac. she has no melena, but reports intermittent nausea with nonbilious vomiting over the last few weeks with the fatigue. . vs in the ed were: 99.2, 97/29, 94, 18, 99% on ra. ng lavage was negative. she was started on 1 unit rbc prior to transfer and was given 1 l ns. past medical history: htn hyperlipidemia type ii diabetes chronic left great toenail fungus/removal nail bed appendectomy tonsillectomy social history: ppd cigarettes, denies ivdu and etoh. she lives in with her husband. she is a retired receptionist. family history: one sister, age 66, with diabetes. one brother with diabetes. otherwise nc physical exam: admission: vs on arrival to the icu: 97.7, 119/45, 85, 18, 99% 2lnc general: elderly woman, comfortable in bed, pale heent: op clear, tachy mm, op clear, conjunctival palor lungs: crackles at bases that clear with cough, no wheezes cardio: rr, loud s2, no murmurs appreciated abd: + bs, soft, ntnd, no hsm ext: trace le edema skin: pale, no petechiae, no ecchymoses neuro: aa, ox3, cn ii - xii grossly normal, gait deferred . discharge: vs: t: 98.9, bp: 132/60, p:96, rr: 18, 99% ra gen: elderly female in nad cv: normal s1, loud s2, rrr, no m/r/g pulm: sparse crackles at bases, ctab at mid/upper lungs abd: bs+, soft, nd, nt ext: amputated l hallux with healing stage ii ulcer, unstagable ulcer on dorsum of l foot, 2+ pe over lle and 1+ over rle pertinent results: hematology: 06:35am blood wbc-9.4 rbc-4.03* hgb-9.9* hct-30.9* mcv-77* mch-24.7* mchc-32.2 rdw-19.3* plt ct-316 05:15pm blood hct-30.1* 06:30am blood wbc-10.0 rbc-3.79* hgb-9.2* hct-28.7* mcv-76* mch-24.2* mchc-31.9 rdw-19.1* plt ct-335 03:57pm blood hct-27.5* 05:13am blood wbc-8.6 rbc-3.76*# hgb-9.1*# hct-28.3*# mcv-75*# mch-24.1*# mchc-32.1 rdw-18.6* plt ct-307 04:30pm blood wbc-7.8 rbc-2.49*# hgb-5.1*# hct-17.0*# mcv-68*# mch-20.6*# mchc-30.2* rdw-15.5 plt ct-459* 04:30pm blood neuts-73.0* lymphs-21.4 monos-4.5 eos-0.4 baso-0.7 04:30pm blood hypochr-3+ anisocy-1+ poiklo-2+ macrocy-normal microcy-3+ polychr-1+ spheroc-occasional ovalocy-normal tear dr1+ fragmen-occasional ellipto-occasional 06:30am blood pt-17.2* inr(pt)-1.5* 05:13am blood pt-21.0* ptt-36.2* inr(pt)-2.0* 04:30pm blood pt-38.5* ptt-42.8* inr(pt)-4.0* 04:30pm blood ret man-3.8* . chemistries: 06:35am blood glucose-122* urean-7 creat-0.6 na-139 k-3.6 cl-103 hco3-27 angap-13 06:30am blood glucose-166* urean-7 creat-0.6 na-139 k-3.1* cl-100 hco3-28 angap-14 05:13am blood glucose-149* urean-22* creat-0.7 na-136 k-3.6 cl-97 hco3-29 angap-14 04:30pm blood glucose-179* urean-32* creat-0.9 na-131* k-4.6 cl-94* hco3-24 angap-18 04:30pm blood alt-13 ast-14 ld(ldh)-171 alkphos-60 totbili-0.3 dirbili-0.1 indbili-0.2 06:35am blood calcium-8.7 phos-2.9 mg-1.5* 06:30am blood calcium-8.9 phos-2.5* mg-1.6 05:13am blood calcium-9.0 phos-3.9 mg-1.7 04:30pm blood totprot-6.4 albumin-3.9 globuln-2.5 calcium-9.3 phos-4.7* mg-1.5* iron-7* 04:30pm blood caltibc-517* hapto-171 ferritn-2.9* trf-398* . antibodies: 06:35am blood igg-729 06:30am blood iga-271 06:30am blood ttg-iga-8 antidgp-3 05:38am blood lactate-1.4 . : ecg: sinus rhythm. indeterminate axis. low limb lead qrs voltage. low inferolateral lead t wave amplitude. findings are non-specific. since the previous tracing of ventricular ectopy is absent and precordial lead t wave changes appear decreased. . : duodenal mucosal biopsy: 1. chronic duodenitis with gastric surface mucous metaplasia. 2. normal villous pattern. no shortening or increased intraepithelial lymphocytes are seen. . : upper endoscopy: #esophagus: lumen: a sliding small size hiatal hernia was seen. no esophagitis noted. #stomach: excavated lesions a single non-bleeding erosion was noted in the pylorus. #duodenum: mucosa: diffuse continuous nodularity, scalloping, and mosaic appearance of the mucosa with no bleeding and scalloping folds were noted in the whole examined duodenum compatible with celiac disease. cold forceps biopsies were performed for histology at the duodenum. . impression: small hiatal hernia erosion in the pylorus nodularity, scalloping, and mosaic appearance in the whole examined duodenum compatible with celiac disease (biopsy) otherwise normal egd to third part of the duodenum . : colonscopy: findings: -flat lesions a few angioectasias that were not bleeding were seen in the cecum. -excavated lesions several non-bleeding diverticula were seen in the descending colon and sigmoid colon. . impression: angioectasias in the cecum diverticulosis of the descending colon and sigmoid colon otherwise normal colonoscopy to cecum brief hospital course: #anemia: was likely the cause of her dizziness and fatigue. iron studies and mcv were consistent with iron deficiency likely chronic blood loss. haptoglobin, ldh, tbili, dbili were normal and were not consistent with hemolysis. lactate was normal and not consistent with bowel ischemia. in the micu she was transfused 3 units of blood. her hematocrit trended from 17-> 28.3->27.5. on transfer to the floor, vital signs were stable and she showed no signs of ongoing bleeding. stool gauic was positive. . #. h/o dvt: pt had dvt in after l first toe amputation. had been on coumadin tx for anti-coagulation. inr on admission was 4 and was reversed to 2 with vitamin k. patient has had 4 months of anti-coagulation and risks of further treatment outweigh the benefits. . #. dm: her home metformin was held while inpatient but was restarted on discharge. she was given a diabetic diet and fingersticks were checked qid fs and she was given humalog insulin sliding scale . #. hyponatremia: as low as 131, normalized over the admission. was likely secondary to fluid administration. . #. copd asthma: -continued on albuterol neb prn for asthma . #. htn: at first , her home atenolol, diovan and hctz were held in the setting of hypotension and possible gi bleed. she was discharged on atenolol 25 mg once a day (prior dose was 50 mg po qd) and valsartan 80 mg po bid. her hydrochlorothiazide was stopped. . #. hyperlipidemia: she was continued on simvastatin 40 mg qd, fish oil. . #. anxiety/depression: she was continued on home cymbalta 30 mg . medications on admission: albuterol prn aspirin 325 mg qd atenolol 50 mg qd coumadin 2.5 mg qd cymbalta 30 mg diovan 80 mg fentanyl 50 mcg patch fish oil mg flovent 2 puffs hctz 25 mg qd hydromorphone 4 mg q4-6 hours prn metformin 1000 mg metformin 500 mg qd (in addition to the above) simvastatin 40 mg qd xalatan eye drops qd discharge medications: 1. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) puff inhalation q6h (every 6 hours) as needed for sob, wheezing. 2. aspirin 81 mg tablet sig: one (1) tablet po once a day. 3. atenolol 25 mg tablet sig: one (1) tablet po daily (daily). 4. cymbalta 30 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. 5. valsartan 80 mg tablet sig: one (1) tablet po bid (2 times a day). 6. fentanyl 50 mcg/hr patch 72 hr sig: one (1) patch 72 hr transdermal q72h (every 72 hours). 7. omega-3 fatty acids capsule sig: one (1) capsule po bid (2 times a day). 8. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 9. hydromorphone 4 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for breakthrough pain. 10. metformin 1,000 mg tablet sig: one (1) tablet po twice a day. 11. metformin 500 mg tablet sig: one (1) tablet po once a day. 12. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 13. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime). 14. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. disp:*30 capsule, delayed release(e.c.)(s)* refills:*2* 15. outpatient lab work check cbc fax results to at . 16. atenolol 25 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* discharge disposition: home with service facility: homecare discharge diagnosis: primary 1. anemia 2. gastrointestinal bleed discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: 1. you were admitted to the hospital because you were having fatigue and dizziness. you doctor checked your labs and you had a very severe anemia. you were given several units of blood to raise the levels of your red blood cells. we tested your stool for blood and it was positive. we were concerned that you were bleeding from your gastrointestinal tract. your colonoscopy showed that no site of active bleeding. the endoscopy of your stomach and small intestine showed some inflammation that may have been the cause of the bleeding. we also took a biopsy. we are still waiting for the results of this biopsy. you will follow up with the gi specialists to discuss the biopsy results. you were started on a medication to help with reducing the acid in your stomach, and you will need to continue this as an outpatient. you will need to have your hematocrit checked at next tuesday, at your primary care doctor's office. the directions for this medication are: omeprazole 40 mg by mouth daily 2. the following changes were made to your medications: stopped coumadin stopped hydrochlorothiazide decreased aspirin from 325 mg to 81 mg once a day decreased atenolol from 50 mg to 25 mg once a day 3. unless otherwise indicated, it is very important that you take your medications as prescribed. 4. it is very important that you keep all of your doctors . followup instructions: name: , location: healthcare - medical group address: ,8th fl, , phone: appointment: , :45am department: gastroenterology when: tuesday at 1 pm with: , md building: campus: east best parking: garage department: vascular surgery when: tuesday at 10:45 am with: , md building: lm campus: west best parking: garage procedure: colonoscopy esophagogastroduodenoscopy [egd] with closed biopsy diagnoses: unspecified essential hypertension iron deficiency anemia secondary to blood loss (chronic) hyposmolality and/or hyponatremia other and unspecified hyperlipidemia long-term (current) use of anticoagulants personal history of venous thrombosis and embolism diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled chronic obstructive asthma, unspecified hemorrhage of gastrointestinal tract, unspecified other toe(s) amputation status diverticulosis of colon (without mention of hemorrhage) angiodysplasia of intestine (without mention of hemorrhage) 

Answer: The patient is high likely exposed to