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: sulfa (sulfonamide antibiotics) / metformin / actos / simvastatin attending: chief complaint: melena major surgical or invasive procedure: egd history of present illness: 82 year old woman with dm2, htn, and h/o stroke on aggrenox who p/w fatigue, exertional dyspnea, and melena. has been fatigued for one week, one large black stool 4 days ago w/ several recurrent black stools of lesser quantity. over same time course noted exertional dyspnea and dizziness. no chest pain, palpitations, or syncope. no hematemesis. no brbpr. no history of gi bleed, does have hiatal hernia. does not take nsaids. . in the ed initial vs were 98.3, 90, 150/64, 18, 100% ra. ekg sr w/ pacs. exam notable for brown stool mixed with black, heme positive. labs notable for hct 24.8 (down from 34.5 in ), bun/cr ratio > 36:1. ng lavage with coffee grounds which cleared with 20cc ns. patient was type and crossed for 4 units and ordered for 2 units prbcs. started on pantoprazole gtt. . on arrival to the micu, patient appears very comfortable and in no acute distress. past medical history: - diabetes - hypertension - hyperlipidemia - gerd - h/o stroke 8 yrs ago, no residual deficits social history: widow. lives alone in a house in , independent in adls. has 2 daughters. at city as a volunteer. never smoked. drinks rare etoh. no illicits. family history: non-contributory physical exam: admission exam: general: alert, oriented x3, no acute distress heent: sclera anicteric, pale conjunctiva, dry mm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: cnii-xii intact, 5/5 strength upper/lower extremities, grossly normal sensation . discharge exam: general: alert, oriented x3, no acute distress heent: sclera anicteric, normal conjunctiva, moistmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: occasional premature beat, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: cnii-xii intact, 5/5 strength upper/lower extremities, grossly normal sensation pertinent results: admission labs: 02:15pm blood wbc-9.0 rbc-3.04* hgb-7.7*# hct-24.8*# mcv-82# mch-25.4*# mchc-31.1 rdw-15.5 plt ct-387# 02:15pm blood neuts-66.1 lymphs-21.8 monos-6.6 eos-5.1* baso-0.4 02:15pm blood pt-10.6 ptt-26.7 inr(pt)-1.0 02:15pm blood glucose-161* urean-37* creat-1.1 na-141 k-4.1 cl-107 hco3-21* angap-17 . discharge labs: . micro: mrsa screen pending. . egd impression: mucosa suggestive of long segment barrett's esophagus - tear large hiatal hernia erythematous prolapsing second part of duodenum mild esophagitis otherwise normal egd to third part of the duodenum 06:21am blood wbc-7.2 rbc-3.59* hgb-9.7* hct-30.2* mcv-84 mch-27.0 mchc-32.2 rdw-15.5 plt ct-287 06:21am blood plt ct-287 06:21am blood glucose-124* urean-16 creat-0.9 na-137 k-4.0 cl-104 hco3-24 angap-13 05:40am blood pt-11.1 ptt-26.4 inr(pt)-1.0 brief hospital course: 82 year old woman with dm2, htn, and h/o stroke on aggrenox who p/w fatigue, exertional dyspnea, and melena, found to have significant hct drop likely due to - tear identified by endoscopy. # - tear: her admission hct was 24.8 and she was transfused with 2 units prbcs with appropriate increase in hematocrit. endoscopy showed tear, esophagitis, possible barrets esophagus. upper gi bleed was attributed to the - tear. patient says she has episodes of vomiting and this likely triggered the tear. her diet was advanced back to a diabetic diet, she was started on omeprazole and placed on an anti-reflux regimen. she was recommended to have a repeat egd in 8 weeks resolution of her tear as well as biopsy her possible barrets esophagus findings. her hct has remained stable. she was discharged on omeprazole 20mg and follow up with gi and told to follow an anti reflux diet: avoid chocolate, peppermint, alcohol, caffeine, onions, aspirin. elevate the head of the bed 3 inches. go to bed with an empty stomach. she was told she needs repeat endoscopy in 8 weeks. # h/o stroke: continued aggrenox. . # htn: initialy atenolol and losartan-hctz in setting of gi bleed, then resumed her home medications. # dm: held glipizide and saxagliptan given pt npo for egd. gave 1/2 dose glargine and hiss while npo. pt will resume her home medications when she leaves hospital. # hld: continued niacin. transitional issues: -needs repeat endoscopy in 8 weeks -further evaluate her episodes of vomiting that initialy triggered the tear medications on admission: 1. atenolol 50mg daily 2. dipyridamole-aspirin (aggrenox) 25mg-200mg er 3. glipizide 10mg 4. insulin glargine 18units sc qhs 5. losartan-hctz 50mg-12.5mg daily 6 niacin er 500mg qhs (recently started) 7. ranitidine 150mg 8. saxagliptin 5mg daily discharge medications: 1. atenolol 50 mg po daily hold: hr<55, bp<100 2. dipyridamole-aspirin 1 cap po bid 3. glipizide 10 mg po bid 4. glargine 18 units bedtime 5. losartan potassium 50 mg po daily hold: bp<100 6. hydrochlorothiazide 12.5 mg po daily hold bp<100 7. niacin sr 500 mg po qhs 8. omeprazole 20 mg po bid rx *omeprazole 20 mg 1 capsule(s) by mouth twice a day disp #*60 tablet refills:*3 9. saxagliptin 5mg daily (home regimen) discharge disposition: home discharge diagnosis: - tear esophagitis upper gi bleed discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to the hospital for a bleed in your gut. you were found to have - tear- a small tear in the esophagus that was causing the bleeding. the endoscopy also showed some inflammation of the esophagus as well as possible esophagus (some changes in the cells of the esophagus that needs further workup). you were given blood through your veins. you stayed in an intensive care unit briefly until your blood counts stabalized. medication changes: start: omeprazole 20mg twice a day. please take this pill every day, twice a day, to decrease the irritation of your esophagus. take the pill 30 minutes before a meal. you may take ranitidine 150mg as needed for burning abdominal pain. follow an antireflux regimen: avoid chocolate, peppermint, alcohol, caffeine, onions, aspirin. elevate the head of the bed 3 inches. go to bed with an empty stomach. you will need a repeat endoscopy in 8 weeks to evaluate the esophagus again. we have arranged for you to see a gut specialist in early . at that appointment, the gi doctor should arrange for a follow up endoscopy of your esophagus. followup instructions: name: , location: health care - adult medicine address: 1000 , , phone: *we are working on a follow up appointment for your hospitalization with your primary care provider. need to be seen within 1 week of discharge. if you have not heard within 2 business days please call the office. department: adult medicine when: friday at 10:45 am with: , md building: (, ma) campus: off campus best parking: free parking on site procedure: other endoscopy of small intestine insertion of other (naso-)gastric tube diagnoses: esophageal reflux other and unspecified hyperlipidemia personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled do not resuscitate status esophagitis, unspecified gastroesophageal laceration-hemorrhage syndrome barrett's esophagus unspecified hypertensive heart disease without heart failure 

Answer: The patient is high likely exposed to