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: penicillins / erythromycin base / ativan attending: chief complaint: anemia major surgical or invasive procedure: egd history of present illness: year old male with stroke , pvd, cad s/p cabg ,and ckd who presents with chief complaint of fatigue and 1 episode of brbpr 1 week ago with black stools since then. routine screening labs done at his facilty detected a hgb of 5.6for which his pcp referred him to the ed. . in the ed, initial vitals were 98.3 103/53 96 16 100%ra. initial hct was 18.5. the patient was guaiac positive. he was also noted to have a positive troponin and lateral st depressions which were attributed to demand ischemia. the patient was transfused 1 units of packed rbcs, a second was ordered and started on a ppi. gi was consulted. his mentation was noted to be slow and off his baseline. . on arrival to the floor, vitals 88 143/70 16 100% 2l. pt reports that he has been feeling fatigued with minimal chest pain. he does endorse worsening shortness of breath and dyspnea on exertion. he notes that his appetite has been decreased for the last several days. he endorses minimal nausea and diarrhea but no vomiting. he states that his legs have been bothering when he stands or walks. he also reports that he has fallen in the past, most recently about 2 weeks ago. he denies headache and dysuria. past medical history: - peripheral vascular disease - s/p left common femoral to anterior tibial angioplasty () now has significant stenosis in the left common femoral artery, moderate stenosis in the popliteal artery. - cad s/p cabg - hypertension - off bp meds since - hyperlipidemia - hypothyroidism - "h/o bradycardia" - h/o diverticulitis - irritable bowel syndrome - hiatal hernia with ge reflux and a lower esophageal ring - chronic kidney disease (baseline cr 2.0 per daughter) social history: lives in in , ma. retired accountant. widowed. has 2 children. a son lives in , , pa. a daughter lives in ma. he eats his breakfasts and dinners in dining . drinks 1 glass of scotch per day. non-smoker. family history: nc physical exam: physical exam vital signs: t- 97.0, hr- 83, bp- 136/65, rr- 18, sao2- 98% on ra general: pleasant, well appearing male in nad heent: normocephalic, atraumatic. conjunctival pallor. no scleral icterus. perrla/eomi. mmm. neck supple, no lad cardiac: regular rhythm, normal rate. normal s1, s2. no murmurs, rubs or . jvp= not elevated lungs: clear to ausculatation bilaterally. good air movement biaterally. abdomen: positive bowel sounds. soft, nt, nd. no hsm extremities: no edema or calf pain, 2+ dorsalis pedis/ posterior tibial pulses. skin: no rashes/lesions, ecchymoses. neuro: a&ox3. appropriate. cn 2-12 grossly intact. preserved sensation throughout. 5/5 strength throughout. + reflexes, equal bl. normal coordination. gait assessment deferred psych: listens and responds to questions appropriately, pleasant pertinent results: admission labs: 11:25am wbc-9.7 rbc-1.92*# hgb-5.6*# hct-18.5*# mcv-96 mch-29.1 mchc-30.3* rdw-15.5 11:25am neuts-67.5 lymphs-21.8 monos-8.1 eos-2.2 basos-0.4 11:25am plt count-401# 11:25am pt-12.9 ptt-22.8 inr(pt)-1.1 11:25am calcium-9.0 phosphate-2.7 magnesium-2.4 11:25am ck-mb-11* mb indx-8.7* 11:25am ctropnt-0.36* 11:25am glucose-108* urea n-39* creat-1.7* sodium-143 potassium-4.4 chloride-109* total co2-26 anion gap-12 11:37am hgb-5.7* calchct-17 09:09pm hct-25.7*# 09:09pm ck(cpk)-98 05:11am blood wbc-9.9 rbc-3.75*# hgb-11.0*# hct-33.2*# mcv-89# mch-29.4 mchc-33.2 rdw-16.4* plt ct-243 12:02pm blood hct-32.1* 08:13pm blood hct-32.6* 06:00am blood wbc-9.3 rbc-3.64* hgb-10.9* hct-32.4* mcv-89 mch-29.9 mchc-33.6 rdw-16.3* plt ct-244 11:25am blood pt-12.9 ptt-22.8 inr(pt)-1.1 05:11am blood pt-13.7* ptt-26.5 inr(pt)-1.2* 06:00am blood plt ct-244 11:25am blood glucose-108* urean-39* creat-1.7* na-143 k-4.4 cl-109* hco3-26 angap-12 05:11am blood glucose-96 urean-32* creat-1.6* na-141 k-4.5 cl-110* hco3-22 angap-14 06:00am blood glucose-78 urean-25* creat-1.5* na-139 k-4.0 cl-106 hco3-23 angap-14 11:25am blood ck(cpk)-127 09:09pm blood ck(cpk)-98 05:11am blood ck(cpk)-96 11:25am blood ctropnt-0.36* 09:09pm blood ck-mb-notdone ctropnt-0.36* 11:25am blood calcium-9.0 phos-2.7 mg-2.4 05:11am blood calcium-8.5 phos-3.2 mg-2.3 ekg ()- sinus arrhythmia with frequent ventricular premature beats. left axis deviation with left anterior fascicular block. right bundle-branch block. inferolateral st-t wave changes that are non-specific. compared to the previous tracing of ventricular premature beats are new egd ()- impression: hiatal hernia erythema in the gastroesophageal junction compatible with barrett's esophagus otherwise normal egd to second part of the duodenum brief hospital course: acute blood loss anemia - remained hemodynamically stable. transfused 4 u prbc with appropriate increase in hct. treated with iv ppi . egd showed hiatal hernia and possible barrett's esophagus but no active source of bleeding. colonscopy planned for however patient determined that he did not want to undergo a colonoscopy. patient's last colonoscopy at least 6 years ago in new jersdy, reportedly negative. dr. had long discussion with daughter who is hcp and overall decision was not to pursue colonoscopy. there is clear understanding that this could be colon pathology including malignancy. patient would not want anything done even if malignancy. patient will not pursue colonoscopy at any point and prefers to be transfused as needed should hematocrit decrease as an outpatient. he ambulated well (without any dizziness or difficulties) and tolerated his diet. upon discharge, he had no more brbpr and his hematocrit was stable at ~33 (18.5 on admission). his aspirin and plavix were held on discharge with plans for primary care physician to decide on resuming them when he sees the patient next week () at his nursing home. troponin leak - seen in consultation by cardiology who felt more consistent with subendocardial/demand ischemia in the setting of obstructive cad and acute blood loss anemia. ekg not significantly changed from prior. continued crestor. aspirin, plavix, metoprolol held. patient denied any chest pain, shortness of breath, headache, dizziness, or syncope. he was monitored on telemetry and no ischemic events were noted. upon discharge, he was stable and asymptomatic. hypothyroidism - continued levothyroxine medications on admission: plavix 75mg daily crestor 20mg daily prilosec 20mg daily ocuvite 2 tablets levothyroxine 88mcg daily mvi 1 tablet daily aspirin 81mg daily discharge medications: 1. fibercon 625 mg tablet sig: one (1) tablet po once a day. 2. multivitamin capsule sig: one (1) capsule po once a day. 3. levothyroxine 88 mcg tablet sig: one (1) tablet po daily (daily). 4. rosuvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 5. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 6. medication please continue your home dose of ocuvite- 2 tablets by mouth twice daily 7. wellbutrin 75 mg tablet sig: one (1) tablet po once a day. discharge disposition: home with service facility: caretenders vna discharge diagnosis: primary: gi bleed secondary: peripheral vascular disease, coronary artery disease, hypertension, hyperlipidemia, hypothyroidism discharge condition: good. vital signs stable. ambulated well. discharge instructions: you were admitted to the hospital for a gi bleed. while here you had a low blood count so you were transfused some blood. you underwent a scope which showed no signs of an upper gi bleed. you decided that you did not want a colonoscopy performed. your blood counts remained stable for multiple days while here. you did not have a bloody bowel movement while here. upon discharge, you were stable and comfortable. the following changes were made to your medications: 1. please discontinue your aspirin until you see your primary care physician next week. 2. please discontinue your plavix until you see your primary care physician next week. if you experience another gi bleed, fevers, chills, vomiting, chest pain, shortness of breath or any other medically concerning symptoms, please contact your primary care physician or go to the emergency department immediately. followup instructions: your primary care physician (dr. ) is aware that you were admitted to the hospital and will come see you at your home within the next week. if you have any questions, please call him at . please discuss restarting aspirin and plavix with him at this appointment procedure: other endoscopy of small intestine diagnoses: esophageal reflux acute posthemorrhagic anemia unspecified acquired hypothyroidism hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status peripheral vascular disease, unspecified chronic kidney disease, unspecified diaphragmatic hernia without mention of obstruction or gangrene other and unspecified hyperlipidemia blood in stool barrett's esophagus irritable bowel syndrome 

Answer: The patient is high likely exposed to