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: ugib major surgical or invasive procedure: esophago-gastro-duodenoscopy (egd) history of present illness: 63 yo m physician with history of hypothyroidism, gerd, colonic adenoma and arthritis presenting about 7-10 days of melena, generalized weakness, and presyncope. patient reports taking 445 mg aleve daily for the last months for his tendonitis as well as asa 81 mg daily for prophylaxis. he stopped his omeprazole about 9 months ago after his gerd symptoms resolved. patient noticed about melena with stomach "queasiness" for about 7-10 days. he also has increased weakness and fatigue. he attribute these symptoms to a viral illness. he denies chest pain, shortness of breath. he denies brbpr. today, he went to see his pcp and was found to have guiaic postive melenic stool with hct down to 27 from previous of 42.8 in 9/. he was referred to the ed for further evaluation. in the ed, initial vs were: t 98.2, hr 67, bp 127/84, rr 18, o2sat 100%. repeat hct was stable at 27.7. patient was started on a protonix infusion at 8mg/hr. gi was consulted and recommended admission to micu for possible egd today. he did not receive blood products. he has 2 peripheral iv 18 gs. vs upon transfer: 97.1, 67, 130/82, 16, 100% ra on arrival to the micu, patient reports feeling okay. past medical history: - ankle sprian - esophageal reflux - hypothyroidism - colonic adenoma - h/o hematuria - basal cell carcinoma ', left malar - htn - hdl social history: patient is an ob/gyn m.d never smoked, does not drink. drinks about cups of coffee daily married. family history: father with htn mother with glaucoma physical exam: admission physical exam: vitals: 98.2, 73, 123/74, rr 16, 96% ra general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: rrr, normal s1 and s2, occasional s3, no m/r/g lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-distended, bowel sounds present, no organomegaly, no tenderness to palpation, no rebound or guarding gu: no foley rectal: dark guaiac + stool ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: cnii-xii intact, 5/5 strength upper/lower extremities, gait deferred. . dicharge physical exam: afebrile, bp 110-120s/60-70s, hr 60s-70s, saturations >98% ra exam unchanged pertinent results: admission labs: 03:51pm blood wbc-6.4 rbc-2.84* hgb-9.0* hct-27.8* mcv-98 mch-31.5 mchc-32.2 rdw-14.2 plt ct-210 03:51pm blood neuts-60.8 lymphs-29.6 monos-5.4 eos-3.6 baso-0.6 03:51pm blood pt-10.8 ptt-29.4 inr(pt)-1.0 03:51pm blood glucose-76 urean-23* creat-1.4* na-137 k-4.5 cl-105 hco3-24 angap-13 03:07am blood calcium-8.3* phos-3.4 mg-2.0 . discharge labs: 08:50pm blood hct-27.2* 07:08am blood hct-26.3* 07:08am blood glucose-97 urean-18 creat-1.5* na-137 k-3.8 cl-103 hco3-25 angap-13 07:08am blood calcium-9.0 phos-3.8 mg-2.3 . egd: esophagus: mucosa: localized erythema of the mucosa with no bleeding was noted in the gastroesophageal junction. these findings are compatible with mild esophagitis. . stomach:mucosa: localized erythema and erosion of the mucosa with no bleeding were noted in the antrum. these findings are compatible with moderate gastritis. . duodenum: mucosa: diffuse erythema, congestion and friability of the mucosa with no bleeding were noted in the duodenal bulb compatible with severe duodenitis. excavated lesions a single non-bleeding 1.5 cm ulcer with clean base was found in the duodenal bulb. there were no stigmata of recent bleed. . impression: erythema in the gastroesophageal junction compatible with mild esophagitis erythema and erosion in the antrum compatible with moderate gastritis erythema, congestion and friability in the duodenal bulb compatible with severe duodenitis ulcer in the duodenal bulb otherwise normal egd to third part of the duodenum . recommendations: the findings account for the symptoms antireflux regimen: avoid chocolate, peppermint, alcohol, caffeine, onions, aspirin. elevate the head of the bed 3 inches. go to bed with an empty stomach. continue protonix drip. serial hct. avoid nsaids. check h.pylori ab in serum and treat if positive. clear liquids today.advance diet today/tomorrow if no further bleeding. if stable, patient can be transferred to floor today/tomorrow. discharge on ppi high dose. brief hospital course: dr. is a 63 year old male with hypothyroidism and left ankle sprain who presented with 7-10 days of melanotic stool and hematocrit drop in the setting of nsaid use x 2-3 months for the ankle sprain. found to have gastritis/duodenitis with duodenal ulcer on egd. . # upper gastrointestinal bleed: because of melena and the hematocrit drop of 14 points (from baseline ), he underwent an egd which showed large 1.5 cm duodenal ulcer with duodenitis, gastritis, esophagitis consistent with nsaid injury. the gi team felt this definitely explained his symptoms and was most likely from chronic nsaid use for left ankle pain (thought to be a acute on chronic sprain in ) and aspirin use. h. pylori igg negative from the clinic, biopsy results pending. patient was started on pantoprazole bolus with drip. serial hematocrit remained stable and did not have further melena during admission. he did not require blood transfusion. he was transitioned from iv pantoprazole to po bid and should continue for 2 weeks then daily until follow-up with gi. . # left ankle sprain: nsaids were stopped due to bleeding above. he will use tylenol for joint pains and this ankle sprain. . # hypothyroidism: he was continued on home levothyroxine 100 mcg daily # hypertension: diet controlled. # hyperlipidemia: diet controlled. . transitional issues: - please follow-up final biopsy results from duodenal ulcer - please encourage adherence to recommended diet medications on admission: - aleve 445 mg - asa 81 mg - levothyroxine 100 mcg daily - mvi daily - fish oil daily discharge medications: 1. levothyroxine 50 mcg tablet sig: two (2) tablet po daily (daily). 2. multivitamin tablet sig: one (1) tablet po daily (daily). 3. omega-3 fatty acids capsule sig: one (1) capsule po daily (daily). 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours) for 2 weeks. disp:*28 tablet, delayed release (e.c.)(s)* refills:*0* discharge disposition: home discharge diagnosis: primary diagnosis duodenal ulcer due to nsaid use anemia of acute blood loss discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear dr. , you were admitted to the hospital because you had melena and a hematocrit drop. you underwent an egd which showed a duodenal ulcer and gastritis/duodenitis. we think that this is due to excessive nsaid intake. you should avoid nsaids completely for at least a month and then only take them sparingly with food. try to use acetaminophen instead for pain but also do not exceed 4 grams per day. also, there are some diet modifications for your ulcer: antireflux regimen: avoid chocolate, peppermint, alcohol, caffeine, onions, aspirin, tomatoe-based foods. elevate the head of the bed 3 inches. go to bed with an empty stomach. the following changes were made to your medications: - increase pantoprazole to 40 mg twice daily for 2 weeks. after this, you can decrease to once daily again - stop taking nsaids, use acetaminophen for pain instead. do not exceed 4 grams of acetaminophen per 24 hours - stop aspirin 81 mg daily until you have completed the 14 days of pantoprazole. if you motice melena again, then you should stop the aspirin and see your pcp or gi doctor. it is very important that you make follow-up appointments with your primary care doctor specialists. it was a pleasure taking care of you in the hospital! followup instructions: please call to make an appointment with your primary care doctor, dr. within 2 weeks. the information is name: , location: - address: , , phone: fax: also, please call to make an appointment with the gi team. you can pick who would like to start seeing as an outpatient. the attending physician on your egd here was dr. . the phone number for gi is: (. procedure: other endoscopy of small intestine diagnoses: esophageal reflux pure hypercholesterolemia unspecified essential hypertension acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction duodenitis, without mention of hemorrhage other specified gastritis, without mention of hemorrhage unspecified analgesic and antipyretic causing adverse effects in therapeutic use unspecified derangement of joint, ankle and foot 

Answer: The patient is high likely exposed to