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: levofloxacin / bactrim attending: chief complaint: maroon stool x 1 major surgical or invasive procedure: persantine mibi stress test small bowel follow through ct-guided biopsy of mesenteric mass history of present illness: pt is an 84 yof w/ h/o metastatic cervical cancer s/p surgery and xrt, chronic diarrhea and malabsorption radiation enteritis, sbo s/p ileocecectomy in , af not on anticoagulation, htn, recent admission in to for gib who p/w 2 days of bilious vomiting and 1 maroon colored stool. . since her last discharge from , she was evaluated in hematology clinic for her malabsorption. she had no further episodes of hematochezia. then, 2 days prior to admission, after eating lunch (soup, crackers, cheese) she developed n/v with over 30-40 episodes of non-bloody, bilious emesis. then, on day of admission, she had llq crampy abd pain () and had 1 marroon bm. . in ed, 98.0, 113, 146/64, 15, 100%ra. k 2.7, which was repleted. hct 32 and repeated 32. ng lavage negative, but guaiac positive. ct abd revealed a soft tissue mass at root of mesentery and duodenum dilated before narrow 3rd portion with wall thickening. she was seen by surgery for obstruction and ? new soft tissue mass below duodenum. she had no ekg changes. . upon arrival to floor, pt reported feeling fatigued after not sleeping. she denied any further bloody/tarry bm, no further n/v or abd pain. she denied any cp, sob, palpitations. no one else in her family has been sick. past medical history: # metastatic cervical cancer - s/p hysterectomy and bilateral iliac lymph node dissections followed by adjuvant radiation therapy at kettering in # chronic diarrhea x 15 years radiation enteritis # s/p sbo requiring ileocecectomy in # gallstones s/p ercp # afib not on anticoagulation # htn # vein stripping # hypothyroidism # gerd # ureteral ca s/p ? resection/chemo (dr. ) # hemorrhoids # femur fracture s/p orif social history: lives in w/ daughter. been visiting son in since who is a professor . husband recently passed away. smoking: never etoh: 1 bourbon/day no drugs family history: no known history of blood disorders in the family. several of her brothers had cancer and a sister had breast cancer. physical exam: t: 98.6 143/74 65 16 97%ra gen: pleasant, well appearing elderly female in nad, ngt in place heent: mild conjunctival pallor. mmm. op clear. neck: supple, no lad, no jvd cv: irreg, irreg. no murmurs, rubs, gallops lungs: ctab abd: soft, nt, nd. healed low midline surgical incision. ext: warm, no edema 2+ dp pulses bl neuro: a&ox3. appropriate. cn 2-12 grossly intact. moving all extremities pertinent results: ***** ct abd/pelvis: findings: ct of the abdomen with iv contrast: the imaged portions of the lungs are unremarkable and there is no pleural effusion or mass. there is right atrial cardiac enlargement. in the abdomen, in the liver, there is unchanged pneumobilia and small hepatic hypodensities, likely cysts. again seen are splenic and hepatic calcifications consistent with granulomas. the kidneys symmetrically take up and excrete contrast and there are numerous unchanged bilateral hypodensities, likely simple cysts. the adrenals and gallbladder appear normal. the pancreas is atrophic. the gastric bubble is significantly distended as is the second portion of the duodenum. at this point at the third portion of the duodenum, there is pronounced bowel wall thickening which extends to the decompressed proximal jejunum which also is thick walled; contrast does pass into the more distal small bowel. immediately inferior to the duodenum and contigous with it is a retroperitoneal soft tissue mass measuring 2.5 x 3.6 cm. this has increased in size since the previous exam. there is no free air or abdominal free fluid, but the vasculature is prominent in the mesentery and there are multiple shotty mesenteric and retroperitoneal nodes. ct pelvis with iv contrast: there has been a hysterectomy and apparent retroperitoneal lymph node dissection. there is a small amount of pelvic free fluid. pelvic loops of bowel do not contain much oral contrast and evaluation is limited; however, there is apparent wall thickening of the rectum and sigmoid. there is no pelvic pathologic lymphadenopathy and no free air. the bladder and distal ureters appear normal. osseous structures: again seen are multiple compression fractures involving l1, l2 and l4. there is severe sclerosis of the si joints bilaterally and a right femoral head screw. impression: 1. dilatation of the stomach and proximal duodenum with a marked caliber change with wall thickening at the third portion of the duodenum. contrast does pass through this region without complete obstruction. interval enlargement of retroperitoneal soft tissue mass just inferior and contigous to this abnormal portion of the duodenum, and the soft tissue mass affecting the adjacent dudoenum is likely. the origin of this soft tissue mass could represent fibrosing mesteritis, metastasis or carcinoid. 2. apparent rectal and sigmoidal bowel wall thickening which may relate to prior radiation treatment for cervical cancer or an acute colitis. evaluation of the bowel is limited by decompression and lack of oral contrast; consider direct visualization. 3. stable appearance of pneumobilia and compression fractures of the lumbar spine. ***** upper gi: upper gi examination: contrast material was administered by mouth. limited views of the esophagus and stomach demonstrate normal filling and emptying without gross abnormalities. contrast flows freely through the second part of the duodenum, where holdup occurred for less than 10 minutes. after minutes, contrast material had passed into the jejunum, although filling of the third and fourth portion of the duodenum was never directly visualized. linear opacity overlying the mid portion of a vertebral body in the expected location the third portion of the duodenum was seen under fluoroscopic evaluation to be associated with the vertebral body rather than the overlying bowel. initial scout view demonstrated surgical clips overlying the lower mid abdomen and residual contrast material in the colon. impression: obstructing mass in the third portion of the duodenum. only after 15 minutes contrast is seen passing into the jejunum. differential diagnosis for the mass include carcinoid or sclerosing mesenteritis. adenocarcinoma of the duodenum seems less likely ***** pmibi: the image quality is adequate. left ventricular cavity size is normal. stress images demonstrate a mild defect in the inferior wall which shows partial reversibility on the rest images gated images reveal normal wall motion. the calculated left ventricular ejection fraction is 64%. impression: partially reversible mild inferior wall defect. normal left vent lvef 64%. brief hospital course: ms. was admitted to the medical service on for chief complaint of maroon colored stool, nausea, and vomiting. ng lavage was negative. her hematocrit was stable. a ct scan in the ed revealed a soft tissue mass in the root of the mesentery near the duodenum, 3-4 cm in size, with narrowingg of the 3rd portion of the duodenum. gi consult was obtained, and an upper endoscopy was performed on . this revealed just mild gastritis, with no stigmata of bleeding or lesions, and the initial report was the the scope was passed to the jejunum without difficulty. this was followed by a sbft, which confirmed an obstructing mass in the 3rd portion of the duodenum, with delayed passage of contrast only after 15 minutes. on she had a brief episode of rapid afib, which was treated successfully with iv lopressor. that evening she had a more extensive run of rapid afib, once again responsive to lopressor, but this time her cardiac enzymes bumped as well. her cardiac treatment was complicated by occasional episodes of bradycardia with increasing doses of lopressor. cardiology consult was called, and her lopressor dose was eventually titrated to 50 mg po bid. she had an endoscopic ultrasound-guided biopsy of the paraduodenal mass on , the results of which were still pending at the time of this summary. she underwent a pmibi on which revealed a partially reversible inferior wall defect with ef of 64%. electrophysiology was consulted as well to assess whether a pacemaker would be indicated, but by this time her tachycardia was relatively well controlled with the lopressor and the pacer was declined. by she was tolerating full liquid diet, so was discharged home with home pt. the plan will be to follow up the final pathology reports and bring her back in an interval of several weeks for excision of the paraduodenal mass. medications on admission: levothyroxine 100 mcg daily digoxin 125 mcg daily atenolol 100 mg daily tylenol#3 prn immodium prn asa 81 mg daily protonix 40 mg daily discharge medications: 1. metoprolol tartrate 50 mg tablet sig: one (1) tablet po every twelve (12) hours: take in morning & at bedtime. . disp:*30 tablet(s)* refills:*2* 2. metoclopramide 10 mg tablet sig: one (1) tablet po qidachs (4 times a day (before meals and at bedtime)). disp:*120 tablet(s)* refills:*2* 3. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 4. codeine sulfate 30 mg tablet sig: 0.5-1 tablet po q 8h (every 8 hours). disp:*90 tablet(s)* refills:*0* 5. levothyroxine 50 mcg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. lorazepam 0.5 mg tablet sig: 0.5 tablet po hs (at bedtime). disp:*15 tablet(s)* refills:*2* 7. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). disp:*15 tablet(s)* refills:*2* discharge disposition: home with service facility: discharge diagnosis: primary: small bowel obstruction retroperitoneal mass tachycardia . secondary: metastatic cervical cancer s/p hysterectomy & b/l iliac ln dissections s/p adjuvant radiation therapy ( kettering), chronic diarrhea x 15 years radiation enteritis, s/p sbo requiring ileocecectomy in , gallstones s/p ercp , afib (no anticoag), htn, vein stripping , hypothyroidism, gerd, ureteral ca s/p ? resection/chemo (dr. ), hemorrhoids, femur fracture s/p orif discharge condition: stable tolerating a regular, soft, low-residue diet adequate pain control with oral medication discharge instructions: please call your doctor or return to the er for any of the following: * you experience new chest pain, pressure, squeezing or tightness. * new or worsening cough or wheezing. * if you are vomiting and cannot keep in fluids or your medications. * you are getting dehydrated due to continued vomiting, diarrhea or other reasons. signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * you see blood or dark/black material when you vomit or have a bowel movement. * your pain is not improving within 8-12 hours or not gone within 24 hours. call or return immediately if your pain is getting worse or is changing location or moving to your chest or back. *avoid lifting objects > 5lbs until your follow-up appointment with the surgeon. *avoid driving or operating heavy machinery while taking pain medications. * you have shaking chills, or a fever greater than 101.5 (f) degrees or 38(c) degrees. * any serious change in your symptoms, or any new symptoms that concern you. * please resume all regular home medications and take any new meds as ordered. * continue to ambulate several times per day. . follow-up: -please call dr. office you have complaints of nausea, vomiting, inability to tolerate food, abdmominal pain, constipation, or any other concerns. -follow-up with dr. in weeks to discuss possible need for surgery in the future. -follow-up with pcp, on discharge for appointment. followup instructions: 1. please make a follow-up appointment with dr. ( in weeks. 2. provider: , md phone: date/time: 10:20 3. provider: , lpn phone: date/time: 11:30 4. follow up with pcp, on discharge for appointment. inquire of need for cardiology follow-up. procedure: other endoscopy of small intestine other endoscopy of small intestine insertion of other (naso-)gastric tube other irrigation of (naso-)gastric tube closed [percutaneous] [needle] biopsy of intra-abdominal mass computerized axial tomography of abdomen diagnoses: subendocardial infarction, initial episode of care esophageal reflux urinary tract infection, site not specified unspecified essential hypertension unspecified acquired hypothyroidism diaphragmatic hernia without mention of obstruction or gangrene other specified cardiac dysrhythmias retention of urine, unspecified other antihypertensive agents causing adverse effects in therapeutic use nonspecific abnormal findings in stool contents other specified intestinal malabsorption personal history of malignant neoplasm of cervix uteri unspecified gastritis and gastroduodenitis, without mention of hemorrhage unspecified intestinal obstruction late effect of radiation radiological procedure and radiotherapy as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure gastroenteritis and colitis due to radiation deficiency of vitamin k unspecified disorder of intestine personal history of malignant neoplasm of other urinary organs 

Answer: The patient is high likely exposed to