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: dark stools major surgical or invasive procedure: egd history of present illness: 68 year old male with pmhx of av block (presumed lyme disease, treated w/ ceftriaxone), hypertension, type 2 diabetes, chronic kidney disease (cr 2.0), inferior mi with systolic chf (ef 35%), several admissions for gi bleeds (most recently with dieulafoy) who presents with 2-3 loose dark black stools yesterday evening. the patient also had some nausea ("stomach queasiness"), dyspnea on exertion yesterday but otherwise asymptomatic - denies vomiting, lightheadedness, hematemesis/coffee grounds, abdominal pain, chest pain. he denies recent nsaid use, alcohol consumption or anticoagulation. his last meal was yesterday evening and did not take his medications this morning. he saw his np yesterday (dr. office) who had started him on furosemide and slow fe, which he took one dose of each. . in the ed, initial vs were: t99.0, hr94, bp148/66 --> sbp110s, rr20, 100% on 4l nasal cannula. he was found to have hct 20.5, down from baseline 26-28, found to be grossly guaiac positive (although brown stools) and persistently tachycardic. he was given iv reglan, lasix 40mg iv, pantoprazole bolus + gtt and started on 2 units prbc. cxr for the shortness of breath was within normal limits. gi is aware of the patient and recommended no lavage, admit to icu for egd/colonoscopy. . on arrival to the micu, t98.1, bp121/63, hr88, 99% on ra. the patient is resting comfortably in bed, lying flat and asymptomatic. . review of systems: (+) per hpi (-) denies fever, chills, headache, or congestion. denies cough, or wheezing. denies chest pain, chest pressure, palpitations, or weakness. denies vomiting, constipation, abdominal pain, dysuria, frequency, or urgency. past medical history: - systolic chf (ef reported at 35%, ) - type 2 diabetes complicated by neuropathy, ckd (a1c 6.1% ) - hypertension - hyperlipidemia - chronic kidney disease (baseline cr 2.0) - chronic anemia (uncertain etiology, baseline high 30s) - chronic leukocytosis () - chronic gi bleeds (see below) - barrett's esophagus - prior sbo secondary to adhesions, s/p lysis of adhesions ** gi bleed history: -: dileufoy lesion in the lesser curvature of the stomach -: a gib at (hct decreased to 20) dieulafoy's or erosion in stomach, had normal colonoscopy at that time -: upper gi bleed thought dieulafoy's and barrett's esophagus s/p two endoclips. -/: upper gi bleed with two endoscopies. 1st endoscopy showed large clot. 2nd endoscopy demonstrated erythema in the duodenal bulb compatible with duodenitis. a red spot was visualized which was injected and given thermal therapy. given ppi drip and erythromycin (to help with gi motility to mobilize visualized clot. social history: lives in with his wife who is bedbound from multiple sclerosis. he is a full time caretaker with his one son that lives at home. retired. former 70 pack year smoker, quit 20 years ago. former beer drinker. denies illicits. family history: mother died of . father died of cancer. grandfather died after 3mi's and dm. physical exam: admission physical exam: general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, ?s3, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: cnii-xii intact, 5/5 strength upper/lower extremities, grossly normal sensation and strength. discharge physical exam: patient appears well, blood pressure 150/80 patient has no rales on exam, but does have mild edema around ankles patient can ambulated down the hallway with ease. no dyspnea/tachypnea and he has a steady gait. pertinent results: labs: on admission: 08:25am blood wbc-15.6* rbc-2.57* hgb-6.5* hct-20.5* mcv-80* mch-25.2* mchc-31.7 rdw-15.7* plt ct-301 08:25am blood neuts-87.0* lymphs-9.8* monos-2.7 eos-0.4 baso-0.1 08:25am blood pt-13.1* ptt-28.3 inr(pt)-1.2* 08:25am blood glucose-215* urean-77* creat-2.2* na-144 k-4.9 cl-113* hco3-18* angap-18 06:45am blood wbc-15.9* rbc-3.55* hgb-9.8* hct-29.0* mcv-82 mch-27.6 mchc-33.7 rdw-16.6* plt ct-244 egd mucosa suggestive of barrett's esophagus blood in the stomach body and duodenum, ulcer in the base of old clips, angioectasia in the lesser curvature of stomach (endoclip) otherwise normal egd to third part of the duodenum. cxr on admission without infiltrate, or chf brief hospital course: 68 year old male with av block, hypertension, hyperlipidemia, type 2 diabetes, chronic kidney disease (cr 2.0), inferior mi with systolic chf (ef 35%), several admissions for gi bleeds who presents with dark loose stools, and found to have acute blood loss anemia and angioectasia of his stomach, as well as duodenitis, s/p clipping of angioectasia. active issues: #. gastrointestinal bleed #. acute blood loss anemia he was admitted to the icu for close monitoring and urgent bedside egd by gi service. transfused 2 units on arrival for hct of 20.5, started on iv ppi drip and promotility dose erythromycin. egd done shortly after arrival showed showed avm in the stomach, which looked to be the source of the bleed and was endoclipped. at this point, erythromycin was stopped. he had one more maroon stool following his procedure and was transfused 1 more unit prbcs, but his hct remained stable. he was transferred to the general medical floor on , and had no further bleeding. his hematocrit on discharge was 29. chronic issues: # hypertension: we held home lisinopril, metoprolol, and furosemide on admission, given gi bleed and potential for hemodynamic instability. these were restarted at discharge. . # chronic systolic chf: ed 35% with significant akinesis/hypokinesis. was started on furosemide as an outpatient the day prior to admission, however this was held on admission given that he had a significant gi bleed and appeared to be compensated. he received furosemide 40 mg po x 1 on the day of discharge, and patient instructed to take furosemide 20 mg starting tomorrow. ? if patient also taking hctz at home. med is on epic medication list, but unclear he should be taking both hctz and lasix concurrently, espcecially with creatinine of 2.2. i have emailed pcp separately to discuss this. # type 2 diabetes: complicated by ckd, retinopathy and neuropathy. continued home lantus and humalog insulin sliding scale . # hyperlipidemia/coronary artery disease: continued high-dose atorvastatin . # first degree av block: thought to be secondary to lyme disease and completed ceftriaxone course . pr interval previously 146, now 134 . key transitional issues: 1. recurrent gi bleeding: he will need gi follow up in 2 weeks, for consideration of non-urgent endoscopy to assess the etiology of his recurrent episodes of bleeding. medications on admission: 1. atorvastatin 80 mg tablet sig: one (1) tablet po once a day. 2. insulin glargine 100 unit/ml solution sig: eighteen (18) units subcutaneous at bedtime. 3. metoprolol tartrate 50 mg tablet sig: one (1) tablet po once a day. 4. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. 5. lasix 20 mg tablet sig: one (1) tablet po once a day. 6. lisinopril 10 mg tablet sig: one (1) tablet po once a day. 7. slow iron discharge medications: 1. atorvastatin 80 mg tablet sig: one (1) tablet po once a day. 2. insulin glargine 100 unit/ml solution sig: eighteen (18) units subcutaneous at bedtime. 3. metoprolol tartrate 50 mg tablet sig: one (1) tablet po once a day. 4. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. 5. lasix 20 mg tablet sig: one (1) tablet po once a day. 6. lisinopril 10 mg tablet sig: one (1) tablet po once a day. discharge disposition: home with service facility: discharge diagnosis: acute blood loss anemia gi bleeding coronary artery disease diabetes mellitus congestive heart failure discharge condition: mental status: clear and coherent, hard of hearing. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted with recurrent bleeding from your stomach. you underwent an endoscopy and they found a blood vessel in your stomach that was bleeding. a clip was placed so that it does not bleed again. please have dr set up a follow up with the gastroenterologists to determine if they need to do another endoscopy document healing of the bleeding blood vessel. you can resume taking your blood pressure medicines tomorrow (lisinopril and metoprolol) as well as the medicine for fluid (lasix) followup instructions: you have an appointment on with , np, at to discuss your hospitalization. procedure: endoscopic control of gastric or duodenal bleeding diagnoses: esophageal reflux congestive heart failure, unspecified acute posthemorrhagic anemia acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes personal history of tobacco use chronic kidney disease, unspecified other and unspecified hyperlipidemia long-term (current) use of insulin old myocardial infarction chronic systolic heart failure barrett's esophagus diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled leukocytosis, unspecified diabetes with ophthalmic manifestations, type ii or unspecified type, not stated as uncontrolled background diabetic retinopathy first degree atrioventricular block angiodysplasia of stomach and duodenum with hemorrhage duodenal ulcer, unspecified as acute or chronic, without hemorrhage or perforation, without mention of obstruction 

Answer: The patient is high likely exposed to