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+<?xml version='1.0' encoding='utf-8'?>
+<topics>
+    <topic number="1" type="diagnosis">A 78 year old male presents with frequent stools and melena.</topic>
+    <topic number="2" type="diagnosis">An elderly female with past medical history of right hip arthroplasty presents after feeling a snap of her right leg and falling to the ground.</topic>
+    <topic number="3" type="diagnosis">A 75F found to be hypoglycemic with hypotension and bradycardia. She had  UA positive for klebsiella. She had a leukocytosis to 18 and a creatinine of 6.  Pt has blood cultures positive for group A streptococcus.  On the day of transfer her blood pressure dropped to the 60s.  She was anuric throughout the day, awake but drowsy.  This morning she had temp 96.3, respiratory rate 22, BP 102/26.</topic>
+    <topic number="4" type="diagnosis">An 87 yo woman with h/o osteoporosis, DM2, dementia, depression, and anxiety presents s/p fall with evidence of C2 fracture, chest pain, tachycardia, tachypnea, and low blood pressure.</topic>
+    <topic number="5" type="diagnosis">An 82 man with multiple chronic conditions and previous surgeries presents with 9 day history of productive cough, fever and dyspnea.</topic>
+    <topic number="6" type="diagnosis">A 94 year old female with hx recent PE/DVT, atrial fibrillation, CAD presents with fever and abdominal pain.  An abdominal CT  demonstrates a distended gallbladder with gallstones and biliary obstruction with several CBD stones.</topic>
+    <topic number="7" type="diagnosis">A 41-year-old male patient with medical history of alcohol abuse, cholelithiasis, hypertension, obesity who presented to his local hospital with hematemasis, abdominal pain radiating to the back and elevated lipase. Signs of ascites, pancytopenia and coagulopathy.</topic>
+    <topic number="8" type="diagnosis">A 26 year-old diabetic woman, estimated to 10 weeks pregnant, presents with hyperemesis.  Her labwork demonstrates a blood glucose of 160, bicarbonate of 11, beta-hCG of 3373 and ketones in her urine.</topic>
+    <topic number="9" type="diagnosis">Infant with respiratory distress syndrome and extreme prematurity.  Chest x-ray shows diffuse bilateral opacities within the lungs, with increased lung volumes.</topic>
+    <topic number="10" type="diagnosis">A 55-year-old woman with sarcoidosis, presenting today with confusion and worsening asterixis.   In the waiting room, the pt became more combative and then unresponsive. Ammonia level 280 on admission.</topic>
+    <topic number="11" type="test">80 yo male with demantia and past medical history of CABG with repeated episodes of chest pain. Admitted for severe chest pain episode.</topic>
+    <topic number="12" type="test">66 yo female pedestrian struck by auto. Unconscious and unresponsive at scene. Multiple fractures and head CT showing extensive interparenchymal hemorrhages.</topic>
+    <topic number="13" type="test">A 43 year old woman with history of transverse myelitis leading to paraplegia, depression, frequent pressure ulcers, presenting with chills, agitation, rigors, and back pain.  Patient has stage IV decubitus ulcers on coccyx and buttocks, heels.  Admission labs significant for thrombocytosis, elevated lactate, and prolonged PT.</topic>
+    <topic number="14" type="test">A 52 year-old woman with history of COPD and breast cancer who presents with SOB, hypoxia, cough, fevers and sore throat for several weeks.</topic>
+    <topic number="15" type="test">67 y.o. male smoker with end stage COPD on home oxygen, tracheobronchomalacia, s/p RUL resection for squamous cell carcinoma. Y-stent placement was complicated by cough and copious secretions requiring multiple therapeutic aspirations. Patient reports decreased appetite, 50 lb wt loss in 6 months.  Decreased activity tolerance.  PET scan revealed some FDG avid nodes concerning for recurrence.  Pt. presents with worsening SOB with R shoulder pain and weakness.</topic>
+    <topic number="16" type="test">A 90+ year old woman who was recently hospitalized for legionella PNA, with confusion and dysarthria the last few days.  Found down in the bathroom this morning, making non-verbal utterances and with minimal movement of the right side.</topic>
+    <topic number="17" type="test">76-year-old female with personal history of diastolic congestive heart failure, atrial fibrillation on Coumadin, presenting with low hematocrit and dyspnea.</topic>
+    <topic number="18" type="test">A 40-year-old woman with a history of alcoholism complicated by Delirium Tremens and seizures 2 years ago, polysubstance abuse, hep C, presents with abdominal pain in lower quadrants, radiating to the back, nausea, vomitting and diarrhea.  Labs are significant for elevated lipase.</topic>
+    <topic number="19" type="test">78 year old female with PMHx HTN, dCHF, Diabetes, CKD, Atrial fibrillation on coumadin, ischemic stroke, admitted after presenting with confusion and somnolence. She was recently discharged after presyncope/falls. Patient has had confusion at home for 3 weeks. The patient denies headache, blurry vision, numbness, tingling or weakness, nausea or vomiting.</topic>
+    <topic number="20" type="test">A 87 yo female reports several days abdominal pain, worse yesterday, severe and more localized to the right, accompanied by nausea and vomitting.  Labs show elevated bilirubin, transaminitis, amylase and lipase.</topic>
+    <topic number="21" type="treatment">A 63 year-old male with biphenotypic ALL, Day +32 after BMT, h/o CMV infection, aspergillus and Leggionare's disease, presents with acute onset of hypoxia accompanied by fever and two days of productive cough.  His CXR showed an opacification of the left basilar lobe and also right upper lobe concerning for pneumonia.</topic>
+    <topic number="22" type="treatment">94 M with CAD s/p 4v-CABG, CHF, CRI presented with vfib arrest.</topic>
+    <topic number="23" type="treatment">85 yo M with PMH of colon CA s/p resection now presenting with black stools and HCT drop.</topic>
+    <topic number="24" type="treatment">51 years-old male with multiple sclerosis and quadriplegia who presents with small bowel obstruction and low urinary output.</topic>
+    <topic number="25" type="treatment">An elderly female with history of atrial fibrillation, Chronic Obstructive Pulmonary Disease, hypertension, hyperlipidemia and previous repair of atrial septum defect, presenting with shortness of breath and atrial fibrillation resistant to medication.</topic>
+    <topic number="26" type="treatment">A 79 year old female wit history of CAD, diastolic CHF, HTN, Hyperlipidemia, previous smoking history, and atrial fibrillation who presents for direct admission from home for progressive shortness of breath. Patient denies recent palpitations, and reports that she has been compliant with all medications. She admits to recent fatigue and 2 pillow orthopnea which has been present for months.  Patient underwent cardioversion and became hypotensive with a junctional rhythm requiring intubation.  She was placed on dobutamine.  Off of dobutamine, cardiac monitoring demonstrated a long QTc and an atrial escape rhythm.</topic>
+    <topic number="27" type="treatment">A 96 y/o female found unresponsive on ground at nursing home pressents with headache, herniation, and some neck/shoulder discomfort. CT head  shows acute left subdural hematoma.</topic>
+    <topic number="28" type="treatment">An 84-year-old man with a previous history of coronary artery disease, presenting with 2 days of melena and black colored emesis.</topic>
+    <topic number="29" type="treatment">This is a 54 year old male patient with an idiopathic pulmonary  fibrosis presenting an acute dyspnea on exertion, secondary to superimposed pneumonia on patient with no pulmonary reserve.  Appears he has been experiencing worsening dyspnea with increased O2 requirement for the last several weeks.</topic>
+    <topic number="30" type="treatment">An 85 year-old woman on  verapamil  presents with junctional heart rhythm in 30s with associated hypotension.</topic>
+</topics>