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: patient recorded as having no known allergies to drugs attending: chief complaint: upper gi bleed major surgical or invasive procedure: placement of right femoral cordis history of present illness: the patient is a 73 y.o. female with h/o duodenal adenocarcinoma (dx in @) h/o epidoses of hematemesis, h/o cad s/p stent placement, ?h/o esophageal cancer? per nursing home records but not found in records from , who presents from a nursing home after an episode of hematemesis. in the ed she was found to be hypotensive to 74/42, tachy to 120s and hct = 23. she was given protonix 40 mg iv x t, ivf, r fem cordis placed, transfused 1 unit then transferred to the micu. of note her ecg in the ed demonstrated st depressions in leads v2 and v3. upon transfer to the micu the patient was tachycardic to 110s, sbps = 90-120. an ngt was placed and ng lavage produced blood which did not clear even after lavaging with 1l. past medical history: pmh: 1. h/o duodenal dysplasia then found to have duodenal adenoca diagnosed at in . not a surgical candidate 2. nstemi in with ef = 60% on echo in with rvh and depressed rvef 3. diabetes. 4. chronic atrial flutter (times 10 years). 5. status post cerebrovascular accident in with residual facial droop. 6. hypertension. 7. status post herniorrhaphy. 8. status post bladder surgery. social history: shx: patient currently lives at house where she was transferred to a hospice program but remains full code. she used to live with her daughter, grandaughter, who is pregnant project in a 2 bedroom appt. the appartment is in her grandmother's name and no one else is on the lease. on a more emotional level her daughter (hcp) would like her mother to meet her unborn baby. apparently when she was well, her mother stated that she wants to live at all cost and her daughter believes that she is not in her right mind because she is so tired because of her illness. family history: brother with heart disease. physical exam: vitals: tm = 99.2, hr = 90s-112, currently 102, bp = 90-120/60-80, gen: thin elderly female, nad, a&o 3. can state name of of president. cv: tachy, nml s1, s2, no m/r/g lungs: ctab abd: soft, nt, guaic negative brown stool. extremities: r femoral cordis in place. no other access besides cordis. pertinent results: admission cxray: impression: 1. findings consistent with congestive heart failure. 2. interval opacity in left lower lung zone; underlying effusion or consolidation cannot be ruled out. ideally, a pa and lateral chest radiograph should be obtained for complete evaluation. * ct abdomen w/contrast 8:57 am ct abdomen w/contrast; ct chest w/contrast reason: hematemesis, esophageal ca, hypotension, ? bleed, ? mass field of view: 32 contrast: optiray medical condition: 73 year old woman with hx of esophageal ca p/w hematemesis, hypotension. reason for this examination: iv contrast eval for bleed. contraindications for iv contrast: none. indication: esophageal cancer and hematemesis. evaluate for hemorrhage and metastatic disease. comparison: cta of the chest dated . technique: contiguous axial images through the chest, abdomen, and pelvis were obtained following the administration of 150 cc of optiray contrast. as the patient was actively bleeding from the upper gi tract, the referring service requested no oral contrast. ct of the chest with iv contrast: there are no pathologically enlarged axillary, mediastinal or hilar lymph nodes that are definitely identified. there is some soft tissue density in the subcarinal region, but a discrete lymph node is not definitely identified. there are small bilateral pleural effusions, and the left pleural effusion tracks medially with a small amount of low-attenuating fluid surrounding the descending thoracic aorta. within the left lung apex, there is a 4 mm nodule which is new compared to the prior study of . no additional lung nodules are identified. there are no consolidations. there is bilateral minimal dependent atelectasis associated with the small pleural effusions. there is no pericardial effusion. the central airways are patent. a small lymph node is noted at the gastroesophageal junction, measuring 7 mm in short axis dimension. ct of the abdomen with iv contrast: the liver, pancreas and adrenal glands are normal. the gallbladder is somewhat distended. there is relative low attenuation that is ill defined in the inferior aspect of the spleen, which is nonspecific. the kidneys enhance symmetrically and excrete normally. there is a rounded hypoattenuating lesion on the lower pole of the right kidney measuring 2.8 x 3.1 cm. it likely represents a cyst, as it measures 8.7 hounsfield units. the stomach contains a fair amount of mixed attenuation material with air. the small bowel is not dilated. the colon is unremarkable. the aorta is of normal caliber, and the celiac, sma, renal arteries and proximal are patent. there is atherosclerosis of the abdominal aorta. small retrocrural lymph nodes are noted, which do not meet ct criteria for pathologic enlargement. they measure approximately 6-7 mm in short axis dimension. small mesenteric lymph nodes are noted that do not meet ct criteria for pathological enlargement as well. ct of the pelvis with iv contrast: the rectum, sigmoid, and uterus are normal. there is a foley catheter within the bladder, with associated air. no pathologically enlarged pelvic or inguinal lymph nodes. bone windows: there is a small amount of cystic change with associated sclerosis of the right ilial portion of the superior sacroiliac joint, likely degenerative. no other osseous lesions are noted. impression: 1. no areas of active extravasation. there is a fair amount of mixed attenuation material within the stomach. 2. a 7-mm lymph node at the gastroesophageal junction and small retrocrural lymph nodes. while these small lymph nodes do not meet ct criteria for pathologic enlargement, attention on follow-up studies is recommended to evaluate for interval growth and evaluation of possible metastases. 3. new 4 mm nodule within the left lung apex. 4. small bilateral pleural effusions. 5. coronary artery calcifications and calcification of the abdominal aorta. * admission ecg: brief hospital course: a/p 73 y. o. female with h/o cad, s/p stent, h/o duodenal cancer, h/o admissions with ugi bleed p/w ugi bleed. ugi bleed: we thought that her hematemesis was most likely secondary to her duodenal cancer. we obtained records from which clearly demonstrated that she had not been considered to be a candidate for surgery and she had refused chemotherapy. she is s/p radiation therapy which she completed in 04/. a ct scan was obtained which did not demonstrate an acute gi process. she was then aggressively transfused and her hct remained stable. the case was discussed with gi who thought that an egd would offer little therapeutic benefit and in light of the risks associated with the procedure an egd was not performed. her hct remained stable and thus her diet was advanced to cld. she was continued on a proton pump inhibitor . * ecg changes: the patient remained chest pain free and cardiac ischemia was ruled out by serial flat cardiac enzymes. she was not given an aspirin in light of her risk of bleeding and she continued on a statin. * fen: she was initially npo and then her diet was slowly advanced to clear liquids. her potassium and magnesium were repleted. her sodium was elevated on the day of discharge and she was encouraged to drink fluids to correct her sodium. her free water deficit was calculated to be 1l. * prophylaxis: she was continued on a proton pump inhibitor , compression boots, subpx: ppi iv bid, scds. sq heparin was held secondary to bleeding. * disposition: to return to today for hospice care. * code status: upon admission she was felt to be cpr not indicated although her code status was a full code. upon discussion with the patient she clearly expressed her desire to be comfortable and she also longed to spend just a few hours at home before she dies. she understands that her family is not able to care for her at home and thus she is willing to return to . after intense discussions the family accepted her wish to be dnr/dni and do not hospitalize. * medications on admission: meds in nh: tylenol lorazepam bisacodyl 10 mg supp ritalin 5 mg morphine 15mg sr mirtazapine 7.5 qhs prochlorperazine 10 mg q 8 prn prochlorperazine 25 mg supp q 8 prn nausea hyoscyamine 0.125 sl prn increased secretions morphine 20 mg /ml give 0.5ml q 1-2 hrs prn pain morphine .75 ml - 15 mg ls prn pain discharge medications: 1. atorvastatin calcium 80 mg tablet sig: one (1) tablet po daily (daily). 2. morphine 10 mg/5 ml solution sig: po q3h (every 3 hours) as needed. 3. pantoprazole sodium 40 mg recon soln sig: one (1) recon soln intravenous q12h (every 12 hours). discharge disposition: extended care facility: - discharge diagnosis: primary: duodenal cancer with upper gi bleed secondary: 1. chf with ef = 60% 2. diabetes. 3. chronic atrial flutter (times 10 years). 4. status post cerebrovascular accident in with residual facial droop. 5. hypertension. 6. status post herniorrhaphy. 7. status post bladder surgery. discharge condition: fair, back to baseline. discharge instructions: dnr/dni transitioning to hospice. followup instructions: please follow up with your doctor . procedure: transfusion of packed cells diagnoses: coronary atherosclerosis of native coronary artery congestive heart failure, unspecified unspecified essential hypertension acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial flutter percutaneous transluminal coronary angioplasty status hemorrhage of gastrointestinal tract, unspecified hyperosmolality and/or hypernatremia malignant neoplasm of duodenum other late effects of cerebrovascular disease, facial weakness 

Answer: The patient is high likely exposed to