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: near syncope episode, s/p fall, upper gi bleed major surgical or invasive procedure: egd history of present illness: this is a 77-year-old male with a history of hypertension, hyperlipidemia on aspirin 81 mg daily for prevention, presenting with near syncopal episodes, sp fall who was transferred from for upper gi bleed. pt is originally from fl and has been in visiting his daughter. on , , he noted to have black stools, no hematochezia, no abdominal pain, that resolved spontaneously. he states it was two large bms. on sat he had a repeat episode and his appeared normal by sun. on monday, he had another large black bm and he felt that his vision was fuzzy when he stood up. he also felt clammy and cold. he moved from the bathroom to the bed and fall down hitting his head on the bed. he did not loose counsciousness. this was witnessed by his wife. his daughter who is an anesthesiologist checked his bp which was 135/60 with a heart rate of 65. no change in wt, no other symtpoms. ems was called and he was taken to ed. in the ed he had ct of head that was negative. he had l head laceration that was repair. he was guaiac positive, hct was 24 and he had blood in the lavage. . he had endoscopy which showed fresh blood and clots with in the fundus of the stomach. he was found to have a small duodenal diverticulum, although there was no visible bleeding it was clipped given this could be possible site. there were no visible bleeding source. he was given a total of 4 units of blood and his hct improved (24->25->27). he had no other episodes of melena. he had a repeat egd today which showed significant reaccumulation of blood and concern for dieulafoy's or subtle avm as noted on discharge note, but there was no gi report from today. he was given a 5th dose of prbcs and was transferred here for for noted. he was then transferred to our hospital for possible angio/bleeding scan. during this whole episode pt has maintained hemodyamically stable. . as per pt he had a normal colonoscopy around 1-1/2 years ago. he denied any nsaid intake or alcohol abuse. he has no history of liver abnormality. he said that his baseline hemoglobin is around 11. he denies having any prior episodes like this. no abd pain, no gerd, no brbpr. no fatigue prior to this episode. no change in wt, no other symtpoms. . on arrival to the unit, pt appears well and is in no acute distress. his vitals are stable with bp in 140s/70s, hr in 70s-80s, rr 20. he had just completed his 5th unit of prbcs. . review of systems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denies cough, shortness of breath, or wheezing. denies chest pain, chest pressure, palpitations, or weakness. denies nausea, vomiting, diarrhea, constipation, abdominal pain. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. past medical history: 1. hypertension. 2. hyperlipidemia. 3. seasonal allergy. 4. last colonoscopy was 1-1/2 years ago, normal per patient. 5. he has a history of anemia with hemoglobin of 11. previous workup was negative per patient. he had a hemoglobin electrophoresis that was negative for thalassemia. social history: he lives at home with wife in . he is independent. he denies any history of smoking or drug abuse. he is a retired cardiologist. he drinks 1 beer a day. family history: noncontributory. physical exam: admission general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear, intact eom, perrla neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, except for scat crackles at bil bases. no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, ii/vi sem on rusb, no rubs, no gallops abdomen: soft, non-tender, mildly distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema. he has dry patches of hyperpigmented skin on bil ankles (l>r) neuro: a+ ox 3, cn ii-xii, symmetrical strength 5/5, intact sensation discharge vitals - tm/tc: 98.4 bp:152/62 (150-152/80-82) hr:61 (61-67) rr:18 02 sat:99% ra general: middle aged male in nad appearing comfortable. heent: a well healing laceration over the right brow/eyelid, sutures and steri strips in place. jvp at 12 cm. chest: ctabl no wheezes, no rales, no ronchi cv: s1 s2 normal in quality and intensity rrr no murmurs rubs or gallops abd: soft, non-tender, non-distended, bs normoactive. no rebound/guarding, neg hsm. neg sign. ext: wwp, no edema. chronic appearing rash over right calf, non tender. dps, pts 2+. pertinent results: cxr : the heart is not enlarged. the aorta is quite tortuous. the vascularity is not expanded. there are no active infiltrates or effusions. . ct head : no acute process. l mca in the sylvian fissure appears focally prominent, measuring 6 mm in diameter, with a focus of calcification (3:11), which is concerning for an aneurysm. recommend head cta on nonemergent basis. . echo at , for new murmur: normal left ventricular cavity size and wall thickness with preserved global and regional biventricular systolic function. mild aortic regurgitation. (lvef >55%) . egd : 1. upon entering the stomach there was fresh blood and clots with pooling mostly in the fundus. this was suctioned and clots flushed away without a localizable source of bleeding. there was mild erosive gastritis, although this was not clearly the source of his bleeding. approximately 20 minutes spent viewing the stomach and repositioning the patient with washings and lavage in an attempt to localize source of bleeding. 2. in the duodenum at the transition point between the first and second portion of the duodenum there was a small duodenal diverticulum which was carefully examined with signs or suggestions of continuous oozing from the orifice of the diverticulum. given that this may have been the chance of bleeding, the diverticulum was clipped closed with a single hemoclip application. hemostasis was achieved. 3. normal-appearing second portion of the duodenum. . admission to 05:59pm blood pt-12.7 ptt-25.1 inr(pt)-1.1 05:59pm blood alt-20 ast-22 alkphos-38* totbili-1.4 05:59pm blood wbc-8.9 rbc-3.51* hgb-10.5* hct-30.1* mcv-86 mch-29.9 mchc-34.7 rdw-16.2* plt ct-220 05:27am blood wbc-8.8 rbc-3.35* hgb-10.1* hct-29.6* mcv-89 mch-30.3 mchc-34.3 rdw-16.2* plt ct-221 07:33am blood wbc-9.0 rbc-3.62* hgb-10.9* hct-31.5* mcv-87 mch-30.1 mchc-34.5 rdw-16.3* plt ct-196 . discharge from 08:35am blood wbc-9.0 rbc-3.74* hgb-11.3* hct-32.7* mcv-87 mch-30.2 mchc-34.6 rdw-16.1* plt ct-199 08:35am blood glucose-115* urean-17 creat-1.1 na-142 k-3.6 cl-108 hco3-25 angap-13 08:35am blood calcium-8.2* phos-2.6* mg-2.1 brief hospital course: 77 yo male with pmh significant for htn, hld on asa 81mg for prevention who presented to on s/p melena x 3days, with near syncope episode with small head laceration. he was transferred to on for upper gi bleed with non-localized source. . # gi bleed: on , patient began experiencing dark stools, for the next two days he continued to have dark stools and on had a syncopal event striking his right brow. he was admitted to and found to have a hct 24 and guiac positive stool, he underent egd x2 with clips placed on three ulcers in the duodenum. he continued to bleed and was transfered to in for evaluation. prior to transfer, he was transfused 5 units with hct ~30. he was admitted to the icu, his hct dropped again to 27 he underwent egd with sclerotherapy and was transfused another unit. h. pylori serologies were checked and were negative. after , his hct was checked four times per day and remained stable x > 48 hours at the time of discharge. he was discharged with pantoprazole 40mg and a plan for repeat hct at his pcp in one week. biopsies taken from the duodenum at for h. pylori were pending at the time of discharge and will need to be followed up by his pcp by calling . . # near syncopal event with head injury: this is most likely due to vasovagal due to hypovolemia r/t gi bleed. his ekg was normal and he had no c/o chest pain. he had no focal deficits on exam, was a+ox3. he had a head ct was negative for acute bleed. he sustained a small laceration over the right palpebra which was treated with sutures and steri-strips. neuro exam remained non-focal throughout hospitalization. he will need to have the sutures removed around and was discharged with a plan for pcp follow up. . # questionable cerebral aneurysm: head ct was performed for head injury which showed a possible aneurysm. patient was asymptomatic. he will need need to have cta as outpatient for followup. . . # hypertension: initially held home lisinopril in the setting of gi bleed. blood pressure increased gradually to 150's systolic. lisinopril 40mg was restarted. for the next two days, sbp remained elevated in 150-160's systolic. on the day of discharge, sbp reached 200 while watching stressful programs on television. ekg was unremarkable and unchanged from prior, he was asymptomatic. blood pressure was treated with clonidine x1 and blood pressure decreased to 140/70 at the time of discharge. amlodipine 5mg daily was added to his outpatient hypertensive regimen. he was discharged with a plan for repeat bp check in one week with medication titration. . # hyperlipidemia: continued crestor. . # murmur: patient noted to have new diastolic murmur. echo in showed normal systolic function and mild aortic regurgitation. . medications on admission: 1. crestor 20 mg p.o. daily. 2. lisinopril 40 mg p.o. daily. 3. aspirin 81 mg p.o. daily. 4. vitamin c. 5. claritin 10 mg p.o. daily. . discharge medications: 1. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours): take twice per day for 8 weeks then change to once daily. disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 2. lisinopril 40 mg tablet sig: one (1) tablet po once a day. 3. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. crestor 20 mg tablet sig: one (1) tablet po once a day. 5. vitamin c oral 6. claritin 10 mg tablet sig: one (1) tablet po once a day. discharge disposition: home discharge diagnosis: primary acute upper gastrointestinal bleed . secondary anemia due do acute blood loss hypertension discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dr. , as you know, you were transfered to from for management of a bleeding duodenal ulcer. you underwent endoscopy with clips placed to stop bleeding. you had lost a lot of blood and were transfused to replace the blood lost. we checked your blood level repeatedly and it was stable for longer than 2 days. you will need to continue to take pantoprazole twice a day for the next 8 weeks then change to daily pantoprazole. we recommend that you stop taking aspirin and discuss with your primary care provider regarding when to resume taking aspirin. we recommend that you avoid nsaids, if you need to take a pain medication, try acetaminophen. we recommend that you follow up with your pcp to have your blood level checked in 5 days. . at the time that you were discharged, pathology results from biopsies taken at were pending, we recommend that your primary care provider to follow up the results of this test. . when you fell, you cut your head and had stitches placed. leave the tape in place, you may shower without restriction, keep the area dry. you will need to have the stitches removed between and . you had a head ct after your fall which did not show any acute bleeding however it did show a finding concerning for an aneurysm. we recommend that you have a repeat head ct with contrast to follow up this finding. . in the days shortly before your discharge from the hospital, your blood pressure was elevated despite having restarted your home lisinopril. we started you on amlodipine for better control. we recommend that you follow up with your primary care provider to check your blood pressure in the next 5 days. . stop taking aspirin 81 mg daily . new medications pantoprazole 40mg twice a day x 8 weeks followed by once a day to treat ulcers amlodipine 5mg daily . continue all of your other medications as directed. followup instructions: name: dr. location: doctors , fl (if you would prefer to be seen in coral office. please call the office they said that would not be a problem) phone: appointment: tuesday 11:30am department: div. of gastroenterology when: wednesday at 1 pm with: , md building: ra (/ complex) campus: east best parking: main garage procedure: endoscopic control of gastric or duodenal bleeding diagnoses: unspecified essential hypertension acute posthemorrhagic anemia other and unspecified hyperlipidemia cerebral aneurysm, nonruptured chronic or unspecified duodenal ulcer with hemorrhage, without mention of obstruction 

Answer: The patient is high likely exposed to