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: hematemasis major surgical or invasive procedure: radiation therapy history of present illness: this is an 83 year old male with a history of dementia, prostate cancer and recent admission for hematemasis found to have likely gastric malignancy on endoscopy who presents from house four hours after discharge with recurrent hematemasis. during the patient's recent admission he presented with hematemasis and melena. he received four units prbcs and underwent endoscopy which revealed oozing mucosa with irregular contour concerning for malignancy. he was monitored for 72 hours with no recurrence of his bleeding and stabilization of his hematocrit. he was discharged to house on . 4 hours after discharge he had recurrent hematemasis. prior to arrival he had had four episodes of bloody emesis with associated nausea and mild abdominal pain. he was brought to ehe emergency room. . in the emergency room his initial vitals were t: 98.0, hr: 70, bp: 115/67, rr: 18, o2: 99% on ra. ng lavage showed bright red which did nto clear. he had an attempt at cordis placement but was not in the correct position and was rewired to a lij central line. hematocrit on arrival was 26.2 from 29.3 the day prior. he was admitted to the micu for further management. . in the micu he received four units of prbcs. he was started on erythromycin. on the night of admission he underwent emergent endoscopy which revealed in the stomach body with no clear site of bleeding. he underwent repeat endoscopy on which revealed no active bleeding. pathology from recent endoscopy with biopsy returned preliminarily with signet cell adenocarcinoma. he is transferred to the floor for further management. . on arrival to the floor he has no complaints. he denies fevers, chills, chest pain, difficulty breathing, nausea, vomiting, abdominal pain, diarrhea, constipation, dysuria, hematuria, leg pain or swelling. all other review of sytems negative in detail. past medical history: dementia recurrent urinary tract infections prostate cancer social history: lives at alf. has a son, , who serves as his health care proxy. - tobacco: denies - alcohol: denies - illicits:denies family history: no history of colon cancer physical exam: admission: vitals: t: 98.0 bp: 134/79 p: 68 r: 18 o2: 98% on ra general: alert, oriented to person not time or place, no acute distress heent: sclera anicteric, conjunctiva pale, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: labs on admission: 09:35am wbc-5.8 rbc-2.96* hgb-8.9* hct-25.7* mcv-87 mch-30.1 mchc-34.8 rdw-15.0 plt ct-176 09:35am plt ct-176 09:35am glucose-95 urean-17 creat-0.6 na-143 k-3.8 cl-111* hco3-25 angap-11 labs on transfer from the icu: 04:00am wbc-10.0 rbc-3.78*# hgb-10.7* hct-31.0* mcv-82# mch-28.4 mchc-34.6 rdw-16.6* plt ct-159 04:00am pt-13.2 ptt-27.0 inr(pt)-1.1 04:00am plt ct-159 04:00am glucose-94 urean-34* creat-0.4* na-140 k-3.5 cl-112* hco3-25 angap-7* labs on discharge: \ 11.3 / 7.5/ 34.5 \ 353 142 | 110 | 6 / 96 3.8 | 23 | 0.5\ urine studies: 11:50am urine rbc-0-2 wbc-0-2 bacteri-few yeast-none epi-0 11:50am urine -neg nitrite-neg protein-tr glucose-neg ketone-tr bilirub-neg urobiln-neg ph-5.0 leuks-neg 11:50am urine color-yellow appear-clear sp -1.018 microbiology: mrsa screen (final ): no mrsa isolated. pathology: stomach, mucosal biopsy : poorly differentiated carcinoma with signet ring features. imaging: chest (portable ap) study date of 1:24 pm impression: nasogastric tube in standard position. left internal jugular approach central venous catheter, with tip terminating in the junction with the left brachiocephalic vein. small patchy focus in right lung base. represent atelectasis and vessel crowding, however small focus of aspiration and/or pneumonia not excluded. ct studies: ct chest w/ contrast : a small amount of oral secretions are seen dependently in the trachea (3:16). there are small bilateral pleural effusions with overlying consolidation, likely atelectatic. a calcific focus in the right lower lobe represents a calcified granuloma. the heart and great vessels are notable for coronary arterial calcification. there is no mediastinal or axillary lymphadenopathy. a left internal jugular central venous line terminates in the left brachiocephalic vein. incidental note is made of bilateral gynecomastia. ct abdomen with and without contrast : the spleen, pancreas, right adrenal gland, and gallbladder are unremarkable. a punctate calcific focus is present in the left adrenal gland. the kidneys enhance and excrete contrast in a symmetric fashion are notable for numerous bilateral hypodensities, some of which are too small to characterize, others of which are consistent with simple cysts. the liver also contains innumerable hypodensities. as was the case in the kidneys, many of these are simple cysts, others of which are too small to characterize. the left lobe is notably atrophic. a soft tissue mass is seen in the retroperitoneum, just posterior to the third portion of the duodenum difficult to precisely marginate, though measuring approximately 50 x 29 mm (3:76). this lesion extends along the anterior surface of the aorta, though does not constrict or deform the otherwise normally opacifying aorta. note is made of a 10-mm left paraaortic retroperitoneal lymph node (3:66). numerous mesenteric lymph nodes are visualized, none of which are enlarged by ct size criteria. ct pelvis with contrast : the urinary bladder contains a foley catheter. the prostate and seminal vesicles are unremarkable. note is made of a large amount of stool in the rectal vault. the remainder of the colon is unremarkable. there is no free gas in the pelvis. a small amount of free fluid is seen dependently in the pelvis. there is no pelvic sidewall or inguinal lymphadenopathy. impression: 1. retroperitoneal lymphadenopathy concerning for metastatic disease 2. bilateral pleural effusions. 3. trace ascites settling dependently in the pelvis. 4. numerous renal and hepatic cysts as well as other renal and hepatic hypodensities, too small to characterize, likely also cysts. ekg : sinus rhythm with ventriculr premature beats. prolonged qtc interval. modest st-t wave changes. findings are non-specific. clinical correlation is suggested for possible drug/electrolyte/metabolic effect. since the previous tracing of borderline sinus tachycardia is absent, ventricular ectopy is seen, the qtc interval appears prolonged and st-t wave abnormalities are decreased. brief hospital course: 83 yo m with recent admission for upper gastrointestinal bleed, found to be h.pylori positive and changes in gastric mucosa concerning for infiltrative process; now readmitted the day after discharge with hematemesis x 7 and ng lavage that returned bright red . . # adenocarcinoma: egd biopsy showed poorly differentiated carcinoma with signet ring features. ct abdomen with evidence of significant lymphadenopathy. surgery, oncology and radiation oncology were consulted. a trial of palliative radiation therepy was suggested to help decrease risk of recurrent gastrointestinal bleeding. patient received 5 of 5 doses of radiation therapy. . # hematemesis: patient with known gastric mucosa abnormality as seen on egd suspicious for infiltrating process with biopsy now showing adenocarcinoma. he was treated with transfusions (4 units on initial admission, 4 units on readmission to the icu from house) and iv ppi. after biopsy showed adenocarcinoma and ct scan of the abdomen showed retroperitoneal mass with associated lymphadenopathy concerning for metastatic disease, oncology was consulted and recommended palliative radiation for control of symptoms of hematemesis. surgery did not feel that the patient's disease could be cured with an operation. subsequently, a family meeting was held on in which it was decided to follow a palliative course of therapy rather than attempting to eradicate the patient's disease. his son and health-care proxy, , agreed to attempt palliate radiation therapy, and a decision was made to work with case management to find a facility where hospice-level care could be administered to the patient upon discharge. the patient was mapped and received his first course of palliative radiation therapy on . patient received 5 of 5 doses of radiation therapy. . # h pylori: h.pylori positive . patient was placed on triple therapy with pantoprazole, clarithromycin, and amoxicillin on . - continue with therapy for h.pylori infection for comfort for total 10 day course - recommend continuation of pantoprazole due to recent gi bleeding. . # ekg changes: patient with new twi in lateral leads compared to prior ekg. nonspecific and denies any localizing symptoms. - cardiac enzymes negative x 2 . #hypertension: the patient's pressure was elevated on arrival but with ongoing loss, decision was made to hold his hydrochlorothiazide and lisinopril. he was not restarted on these medications during his hospital stay; bp has remained stable despite being off of antihypertensives. . #alzheimer's dementia: stable. - held namenda and aricept initially in the setting of gi bleed, but were subsequently resumed. . # h/o metastatic prostate cancer: previously on bicalutamide. - discontinued due to changes in goals of care . # hyperlipidemia: patient's atorvastatin was discontinued due to changes in goals of care. . disp: discharge to hospice today, after last dose of xrt. ppx: at risk for dvt. pt received pneumoboots in setting of gi bleed. medications on admission: lansoprazole 30 mg po bid amoxicillin 1000 mg po bid clarithromycin 500 mg po bid memantine 5 mg po daily donepezil 5 mg po hs atorvastatin 10 mg po daily bicalutamide 50 mg po daily acetaminophen 325 mg po bid loperamide 2 mg po bid prn diarrhea discharge medications: 1. acetaminophen 325 mg tablet : 1-2 tablets po q6h (every 6 hours) as needed for pain/fever. 2. donepezil 5 mg tablet : one (1) tablet po hs (at bedtime) as needed for alzheimer's. 3. memantine 5 mg tablet : one (1) tablet po daily () as needed for alzheimer's. 4. amoxicillin 250 mg/5 ml suspension for reconstitution : 1000 (1000) mg po bid (2 times a day) for 6 days. 5. clarithromycin 250 mg tablet : two (2) tablet po bid (2 times a day) as needed for h.pylori therapy for 6 days. 6. pantoprazole 40 mg tablet, delayed release (e.c.) : one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 7. ondansetron 4 mg tablet, rapid dissolve : two (2) tablet, rapid dissolve po daily (daily) as needed for nausea. discharge disposition: extended care facility: house discharge diagnosis: # gastric adenocarcinoma # hematemesis # h. pylori infection # dementia, alzheimers # h/o metastatic prostate cancer discharge condition: mental status: confused - always level of consciousness: alert and interactive activity status: ambulatory - requires assistance or aid (walker or cane) discharge instructions: you were admitted for vomiting , and you were found to have an uncurable cancer in your stomach. to help control the bleeding, you have been receiving radiation therapy. you are being discharged to hospice care. followup instructions: please follow up with hospice care for ongoing care. procedure: venous catheterization, not elsewhere classified other endoscopy of small intestine other endoscopy of small intestine other radiotherapeutic procedure diagnoses: acute posthemorrhagic anemia other and unspecified hyperlipidemia malignant neoplasm of prostate encounter for palliative care hematemesis alzheimer's disease dementia in conditions classified elsewhere without behavioral disturbance helicobacter pylori [h. pylori] secondary and unspecified malignant neoplasm of intra-abdominal lymph nodes benign essential hypertension personal history, urinary (tract) infection malignant neoplasm of body of stomach malnutrition of mild degree 

Answer: The patient is high likely exposed to