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: demerol attending: chief complaint: bleeding sphincterotomy site major surgical or invasive procedure: mesenteric angiogram history of present illness: 71 yo woman who is a poor historian and has a ten-month history of "feeling sick to my stomach" associated with progressive (20 pound) weight loss. patient unable to further characterize this sensation. she may have nausea but has not had emesis; she may sometimes have dry heaves. she has had progressive anorexia. she denies fevers, although she has occasional chills. she also reports sweats that sometimes soak through her bed clothes. there is no abdominal pain, diarrhea, constipation, odynophagia, or dysphagia. all of her symptoms got worse two months ago and then got worse again five days ago. there is some question as to whether or not all of her symptoms are due to chronic narcotic (oxycontin) use for djd pain. although there is no other information available, presumably no etiology of her symptoms has been identified. for evaluation of her acute-on-chronic discomfort, lfts were ordered earlier this week and were mildly elevated. an abdominal ct scan was therefore performed that showed l intrahepatic ductal dilatation (mild-to-moderate) and a low-density area in the head of pancreas (separate from the duodenum). given concern for a neoplasm of the pancreas, ampulla, or cbd, or porta hepatis nodes causing intermittent biliary obstruction, she was admitted to an osh for further w/u. ercp was therefore done . during this study, sphincterotomy and stenting (of the cbd?) were performed. there was a small sphincterotomy bleed that stopped spontaneously (3cc), as well as a difficult cannulation and possible submucosal injection. on , the patient had a falling hct and brbpr. repeat egd with a side-viewing scope showed a sphincterotomy bleed. multiple injections with epinephrine were done with temporary control of bleed, but a nearby site subsequently started to bleed rapidly. in addition, the stent was no longer seen. she was given two units of ffp and two units of prbc and was transferred to the micu for further evaluation. ... pt transfer to on evening of at which time she received 2 more units of prbcs and 2 units of ffp. ir attempted to located source of bleed for embolectomy - but unable to identify source at time of intervention, so prophylactically embolized gastroduodenal artery. pts hct has been stable since that time and she was trasnfered to the floor . she states that although stool still dark, the amount of brbpr has decreased. stent dislodged and moving down through gi tract. past medical history: 1. pvd 2. bilateral cea 3. pud s/p nsaid-induced ugi bleed 4. gerd 5. chronic djd (on low-dose narcotics) 6. small aaa 7. 2v-cad s/p lad stent 8. dyslipidemia 9. paroxysmal afib s/p dccv ~10 years ago 10. anxiety 11. remote etoh abuse 12. migraine headaches social history: active smoker with ~50 pack-year smoking history. currently smokes cigarettes daily. no current alcohol use. denies illicit drug use. family history: sister and father had rectal cancer. one cousin had another unknown malignancy. extensive cardiac disease on both sides of the family. physical exam: temp 98.1, bp 140/62, hr 76, rr 16, spo2 98% ra gen: pleasant woman, appears stated age, non-toxic heent: no sinus tenderness, perrl, op clear, mm slightly dry neck: soft, supple, no carotid bruits, no cervical adenopathy cv: rrr with ectopy, normal s1 and s2, ii/vi hsm throughout precordium pulm: bibasilar crackles, coarse breath sounds, scattered rhonchi, no wheezes abd: soft, ntnd, active bs, no hsm back: no cva or spinal tenderness ext: no edema, 2+ dp pulses skin: multiple seborrheic keratoses pertinent results: wbc-9.3 (n-81.3 l-14.0 m-4.5) hct-28.0 mcv-83 plt-173 pt-13.4 ptt-27.4 pt-1.1 na-130 k-3.0 cl-93 bicarb-30 bun-13 cr-0.9 glu-90 ca-8.0 mg-1.2 phos-2.8 alt-78 ast-48 alk phos-139 tbili-0.8 -267 lip-390 osh labs ( at 1508): wbc-21.0 (n-91 band-1 l-4 m-4) hct-34.1 mcv-86 plt-221 pt 11.7, aptt 27.4 na-123 k-3.8 cl-88 bicarb-24 bun-14 cr-1.1 glu-382 ca-7.4 at 0700: alt-57 ast-23 alk phos-159 tbili-0.5 alb-4.0 at 1500: alt-120 ast-121 alk phos-215 tbili-0.5 alb-3.7 osh ekg (): nsr at 55 bpm, normal axis, normal intervals, mildly delayed r wave progression, no ischemic st segment or t wave changes. brief hospital course: 1. bleeding sphincterotomy site: sphincterotomy at osh has been complicated by post-procedural bleeding. the gi fellow discussed the case at length with gi attending at osh earlier today. given the difficulties achieving hemostasis while using the side-viewing scope earlier today, there appears to be no role for repeat egd with a side-viewing scope at this time. also, there was initially concern of the possibility that there may have been migration of the stent upwards into the biliary tree. the bleeding is also clearly worsened by her recent clopidogrel use. as above, on evening of pt underwent coil embolization of gastroduodenal artery by ir. following intervention, her hct was checked q6hrs in icu and remained stable around 32-34. she continued to have melanotic stools residual blood in tract. kub was done to localize stent on admission (to determine location: in place in biliary tree vs. in intestinal tract vs. migrated upwards into biliary tree), which was seen initially in lower right quadrant on admission(ie moving down through gi tract) and no longer visible on repeat kub , therefore assuming that stent was passed with stool. hct remained stable throughout remainder of hospitalization at without further transfusions. 2. nausea and weight loss: etiology unclear, although weight loss with drenching sweats raises concern for a primary malignancy. her recent ct reportedly showed a mass near the pancreatic head. there is no ercp report available, so it is not clear if a mass at the head of the pancreas was seen. other possibilities include a primary pulmonary malignancy (maybe non-small cell with associated siadh given her hyponatremia) or a gi malignancy (esophageal? gastric cancer?) given her difficulty with nausea and trouble swallowing. there is no palpable cervical adenopathy, although lymphoma is also on the differential. presumably she is up-to-date on her colon cancer screening given her extensive family history, although this should be verified. narcotics may also be playing a role here. per dr. request she will be transfered back to on for further w/ seen on ct. 3. hyponatremia: suspect hypovolemic hyponatremia due to bleeding and poor po intake recently. hctz may also be contributing. she was given ns with improvement of serum sodium(130 on admission to 137 on d/c). hctz continued to be held during admission and on transfer. 4. hyperlipasemia/amylasemia: likely related to mild, post-ercp pancreatitis. asymptomatic. pt was already npo for ? need for further intervention. amylase/lipase and lfts all normalized by . morning of pt said that she had appetite for the first time in months, and diet was advanced. while she tolerated diet without n/v, her appetite was still not impressive when food came and only nibbled at meals. ivfs at maintance levels were continued. 5. leukocytosis: noted at osh but now resolved. etiology unclear; may simply be a stress response to this acute episode. there are no reports that the patient has been febrile at the osh, although no notes are available. there reportedly was no concern for cholangitis on admission to the osh. also possible is post-ercp pancreatitis given the mildly elevated amylase and lipase. pt remained afebrile without increase in wbc throughout admission. 6. cad: stable. given concern for bleeding, clopidogrel (which she has been taking for stents placed ) was held; unclear if she still needs this medication. will leave up to pcp on discharge. clopidegrel continued to be held at time of transfer. no asa given h/o ugi bleed. continued atenolol and atorvastatin at outpt doses during admit and on transfer. 7. htn: not hypertensive on admission. continued atenolol. nifedipine was initally held but restarted without complications on . hctz continued to be held at time of transfer. 8. gerd: pantoprazole 40 mg orally twice daily. 9. djd: pain control with methadone, gabapentin as per baseline. 10. f/e/n: iv fluids, npo initially and advanced diet when hct stable and amylase/lipast normalized on , pt continued to have poor intake and ivs continued at maintanence. repleted k and mg as necessary. 11. proph: ppi as above, pneumoboots 12. code: full 13. dispo: will transfer back to st for further w/ seen on ct medications on admission: 1. methadone 20 mg orally twice daily 2. metoclopramide 10 mg orally twice daily 3. gabapentin 300 mg orally three times daily 4. nifedipine 60 mg orally once daily 5. atenolol 100 mg in the morning, 50 mg at night 6. clopidogrel 75 mg orally once daily 7. hctz 25 mg orally once daily 8. alprazolam 0.5 mg as needed for anxiety 9. pantoprazole 40 mg twice daily discharge medications: 1. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 2. atenolol 100 mg tablet sig: one (1) tablet po qam (once a day (in the morning)). 3. atenolol 50 mg tablet sig: one (1) tablet po qpm (once a day (in the evening)). 4. methadone hcl 10 mg tablet sig: one (1) tablet po bid (2 times a day). 5. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed for pain. 6. gabapentin 300 mg capsule sig: one (1) capsule po q12h (every 12 hours). 7. zolpidem tartrate 5 mg tablet sig: one (1) tablet po hs (at bedtime) as needed. 8. nifedipine 30 mg tablet sustained release sig: one (1) tablet sustained release po daily (daily). discharge disposition: extended care facility: hospital, discharge diagnosis: primary 1. upper bleed secondary to sphincterotomy w/ significant blood loss 2. embolization of gastroduodenal artery 3. pancreatic mass (from report from ct scan from osh) secondary 1. chronic nausea/anorexia/weight loss 2. peptic ulcer disease 3. coronary artery disease 4. severe degenerative joint disease primary 1. upper bleed secondary to sphincterotomy w/ significant blood loss 2. embolization of gastroduodenal artery secondary 1. chronic nausea/anorexia/weight loss 2. peptic ulcer disease 3. coronary artery disease 4. severe degenerative joint disease discharge condition: stable w/ hematocrit 30-34 for the past 3 days discharge instructions: pt being transfered back to for further work up and evaluation of mass seen near pancreatic head on ct. hct stable 30-33 s/p coil embolization of gastroduodenol artery by ir on . please continue to monitor hct closely. followup instructions: continue work-up for abdominal problems and chronic nausea and weight loss at saints- with pcp . () and gastroenterologist dr. . procedure: arteriography of other intra-abdominal arteries other endovascular procedures on other vessels diagnoses: esophageal reflux unspecified essential hypertension iron deficiency anemia secondary to blood loss (chronic) hyposmolality and/or hyponatremia coronary atherosclerosis of unspecified type of vessel, native or graft percutaneous transluminal coronary angioplasty status hemorrhage complicating a procedure cardiac pacemaker in situ 

Answer: The patient is high likely exposed to