🩺 FMGE High-Yield: Obstetrics & Gynecology

ls -la /home/daytona/workspace/ 2>/dev/null || echo "workspace empty or not foun…

mkdir -p /home/daytona/workspace/fmge-obg-flashcards && python3 -c "import repor…

~/fmge-obg-flashcards/make_flashcards.py

from reportlab.lib.pagesizes import A4
from reportlab.lib import colors
from reportlab.lib.units import cm
from reportlab.platypus import (
    SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle, PageBreak, HRFlowable
)
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.enums import TA_CENTER, TA_LEFT
from reportlab.platypus import KeepTogether

OUTPUT = "/home/daytona/workspace/fmge-obg-flashcards/FMGE_OBG_Flashcards.pdf"

# ── colour palette ──────────────────────────────────────────────────────────
C_HEADER     = colors.HexColor("#1A3C6E")   # dark navy
C_MNEMONIC   = colors.HexColor("#E8F4FD")   # light blue bg
C_DRUG       = colors.HexColor("#FEF9E7")   # light amber bg
C_FRONT_TXT  = colors.HexColor("#FFFFFF")
C_BACK_TXT   = colors.HexColor("#1A1A1A")
C_ACCENT     = colors.HexColor("#E74C3C")   # red accent
C_GREEN      = colors.HexColor("#1E8449")
C_BORDER_M   = colors.HexColor("#2980B9")   # blue border
C_BORDER_D   = colors.HexColor("#E67E22")   # orange border

doc = SimpleDocTemplate(
    OUTPUT,
    pagesize=A4,
    leftMargin=1.5*cm, rightMargin=1.5*cm,
    topMargin=1.5*cm,  bottomMargin=1.5*cm,
)

styles = getSampleStyleSheet()

# Custom styles
title_style = ParagraphStyle("Title", parent=styles["Title"],
    fontSize=22, textColor=C_FRONT_TXT, alignment=TA_CENTER,
    fontName="Helvetica-Bold", spaceAfter=4)

subtitle_style = ParagraphStyle("Subtitle", parent=styles["Normal"],
    fontSize=11, textColor=C_FRONT_TXT, alignment=TA_CENTER,
    fontName="Helvetica", spaceAfter=6)

section_style = ParagraphStyle("Section", parent=styles["Normal"],
    fontSize=14, textColor=C_FRONT_TXT, alignment=TA_CENTER,
    fontName="Helvetica-Bold", spaceAfter=2)

q_style = ParagraphStyle("Q", parent=styles["Normal"],
    fontSize=13, textColor=C_HEADER, fontName="Helvetica-Bold",
    leading=16, spaceAfter=4, alignment=TA_LEFT)

a_style = ParagraphStyle("A", parent=styles["Normal"],
    fontSize=11, textColor=C_BACK_TXT, fontName="Helvetica",
    leading=15, spaceAfter=2, alignment=TA_LEFT)

label_style = ParagraphStyle("Label", parent=styles["Normal"],
    fontSize=8, textColor=colors.grey, fontName="Helvetica-Oblique",
    alignment=TA_LEFT)

bullet_style = ParagraphStyle("Bullet", parent=styles["Normal"],
    fontSize=10.5, textColor=C_BACK_TXT, fontName="Helvetica",
    leading=14, leftIndent=10, spaceAfter=1)

# ── helper: render one flashcard row (front | back) ─────────────────────────
def flashcard(num, category, front_q, back_lines, card_type="mnemonic"):
    bg   = C_MNEMONIC if card_type == "mnemonic" else C_DRUG
    bdr  = C_BORDER_M if card_type == "mnemonic" else C_BORDER_D
    icon = "🧠" if card_type == "mnemonic" else "💊"
    cat_color = C_BORDER_M if card_type == "mnemonic" else C_BORDER_D

    # Front cell
    front_content = [
        Paragraph(f'<font color="#888888" size="8">#{num} · {category}</font>', label_style),
        Spacer(1, 4),
        Paragraph(f'{icon} {front_q}', q_style),
    ]

    # Back cell — bullet lines
    back_content = [
        Paragraph('<font color="#888888" size="8">ANSWER</font>', label_style),
        Spacer(1, 4),
    ]
    for line in back_lines:
        if line.startswith("**") and line.endswith("**"):
            # Bold heading
            back_content.append(
                Paragraph(f'<b><font color="{bdr.hexval()}">{line.strip("*")}</font></b>', bullet_style)
            )
        elif line.startswith("•"):
            back_content.append(Paragraph(line, bullet_style))
        else:
            back_content.append(Paragraph(line, a_style))

    table = Table(
        [[front_content, back_content]],
        colWidths=[8.5*cm, 8.5*cm],
        rowHeights=None,
    )
    table.setStyle(TableStyle([
        ("BACKGROUND",    (0,0), (0,0), bg),
        ("BACKGROUND",    (1,0), (1,0), colors.HexColor("#FAFAFA")),
        ("BOX",           (0,0), (-1,-1), 1.5, bdr),
        ("LINEAFTER",     (0,0), (0,0), 1, bdr),
        ("VALIGN",        (0,0), (-1,-1), "TOP"),
        ("TOPPADDING",    (0,0), (-1,-1), 8),
        ("BOTTOMPADDING", (0,0), (-1,-1), 8),
        ("LEFTPADDING",   (0,0), (-1,-1), 10),
        ("RIGHTPADDING",  (0,0), (-1,-1), 10),
        ("ROUNDEDCORNERS", [6]),
    ]))
    return KeepTogether([table, Spacer(1, 0.35*cm)])


# ── cover page ───────────────────────────────────────────────────────────────
def cover():
    cover_data = [[
        Paragraph("FMGE High-Yield", title_style),
        Spacer(1, 6),
        Paragraph("OBG Flashcards", title_style),
        Spacer(1, 10),
        Paragraph("Mnemonics &amp; Drugs", subtitle_style),
        Spacer(1, 6),
        Paragraph("Obstetrics · Gynaecology · Pharmacology", subtitle_style),
    ]]
    cover_table = Table(cover_data, colWidths=[17*cm])
    cover_table.setStyle(TableStyle([
        ("BACKGROUND",    (0,0), (-1,-1), C_HEADER),
        ("BOX",           (0,0), (-1,-1), 2, C_BORDER_D),
        ("TOPPADDING",    (0,0), (-1,-1), 30),
        ("BOTTOMPADDING", (0,0), (-1,-1), 30),
        ("LEFTPADDING",   (0,0), (-1,-1), 20),
        ("RIGHTPADDING",  (0,0), (-1,-1), 20),
    ]))
    return [cover_table, Spacer(1, 0.5*cm)]


def section_banner(title, subtitle=""):
    content = [Paragraph(title, section_style)]
    if subtitle:
        content.append(Paragraph(subtitle, subtitle_style))
    t = Table([[content]], colWidths=[17*cm])
    t.setStyle(TableStyle([
        ("BACKGROUND",    (0,0), (-1,-1), C_HEADER),
        ("TOPPADDING",    (0,0), (-1,-1), 10),
        ("BOTTOMPADDING", (0,0), (-1,-1), 10),
        ("LEFTPADDING",   (0,0), (-1,-1), 12),
        ("RIGHTPADDING",  (0,0), (-1,-1), 12),
    ]))
    return [t, Spacer(1, 0.3*cm)]


# ════════════════════════════════════════════════════════════════════════════
# FLASHCARD DATA
# ════════════════════════════════════════════════════════════════════════════

mnemonic_cards = [
    # (front_question, [back_lines], category)
    (
        "What do the 4 T's of PPH stand for?",
        [
            "**4 T's of PPH (Primary)**",
            "• <b>T</b>one — Uterine atony (most common, ~80%)",
            "• <b>T</b>rauma — Lacerations, uterine rupture",
            "• <b>T</b>issue — Retained placenta/membranes",
            "• <b>T</b>hrombin — Coagulopathy (DIC, ITP)",
            "",
            "PPH = ≥500 mL (vaginal) / ≥1000 mL (LSCS)",
        ],
        "PPH"
    ),
    (
        "What does HELLP syndrome stand for?",
        [
            "**HELLP Syndrome**",
            "• <b>H</b> — Haemolysis",
            "• <b>EL</b> — Elevated Liver enzymes",
            "• <b>LP</b> — Low Platelets (<100,000)",
            "",
            "Variant of severe pre-eclampsia",
            "Rx: Stabilise → Deliver (definitive)",
        ],
        "Pre-eclampsia"
    ),
    (
        "What is the PALM-COEIN classification for AUB?",
        [
            "**AUB — PALM-COEIN (FIGO 2011)**",
            "<b>PALM</b> (Structural):",
            "• Polyp · Adenomyosis · Leiomyoma · Malignancy",
            "<b>COEIN</b> (Non-structural):",
            "• Coagulopathy · Ovulatory · Endometrial",
            "• Iatrogenic · Not yet classified",
        ],
        "Menstrual Disorders"
    ),
    (
        "Rotterdam criteria for PCOS — recall the 3 components",
        [
            "**Rotterdam (2003) — diagnose 2 of 3:**",
            "• <b>O</b>ligo/anovulation (irregular cycles)",
            "• <b>H</b>yperandrogenism — clinical or biochemical",
            "• <b>P</b>olycystic ovaries on USG (≥12 follicles or volume >10 mL)",
            "",
            "LH:FSH ratio > 2:1 (supportive, not diagnostic)",
        ],
        "PCOS"
    ),
    (
        "ABCDE mnemonic for Hydatidiform Mole",
        [
            "**Mole — ABCDE**",
            "• <b>A</b>menorrhoea",
            "• <b>B</b>leeding (irregular vaginal bleeding)",
            "• <b>C</b>oagulation failure (DIC)",
            "• <b>D</b>istension — uterus large for dates",
            "• <b>E</b>clampsia occurring early (before 20 wks)",
            "",
            "Complete mole: 46XX | Partial mole: 69XXY",
        ],
        "GTD"
    ),
    (
        "Cardinal movements of labor — in order",
        [
            "**DEFIRE + E (8 movements)**",
            "• <b>D</b>escent",
            "• <b>E</b>ngagement",
            "• <b>F</b>lexion",
            "• <b>I</b>nternal rotation",
            "• <b>E</b>xtension",
            "• <b>R</b>estitution (external rotation)",
            "• <b>E</b>xpulsion",
            "",
            "Mnemonic: 'Doctors Every Friday Invite Excellent Resident Experts'",
        ],
        "Normal Labor"
    ),
    (
        "What does PROM / PPROM stand for and how do you confirm it?",
        [
            "**PROM vs PPROM**",
            "• PROM = Premature Rupture Of Membranes (at term)",
            "• PPROM = Preterm PROM (before 37 weeks)",
            "",
            "<b>Confirmation triad:</b>",
            "• Pooling of fluid in posterior fornix",
            "• Nitrazine (pH) test — turns blue (alkaline amniotic fluid)",
            "• Ferning on microscopy",
        ],
        "PROM"
    ),
    (
        "Fetal heart rate decelerations — Type I, II, III",
        [
            "**FHR Decelerations**",
            "• <b>Type I (Early)</b> — Head compression; benign; mirrors contraction",
            "• <b>Type II (Late)</b> — Uteroplacental insufficiency; ominous",
            "• <b>Variable</b> — Cord compression; V/W shaped",
            "• <b>Sinusoidal</b> — Fetal anaemia (Rh isoimmunisation, vasa previa)",
            "",
            "Mnemonic: <i>HUC-A</i> = Head, Uteroplacental, Cord, Anaemia",
        ],
        "Fetal Monitoring"
    ),
    (
        "Staging of cervical cancer (FIGO) — key landmarks",
        [
            "**Cervical Cancer FIGO Staging**",
            "• Stage I — Confined to cervix",
            "• Stage IIA — Upper 2/3 vagina involved",
            "• Stage IIB — Parametrium involved (not pelvic wall)",
            "• Stage IIIB — Pelvic wall / hydronephrosis",
            "• Stage IVA — Bladder / rectum involved",
            "• Stage IVB — Distant metastasis",
            "",
            "Staging is <b>CLINICAL</b> (not surgical)",
        ],
        "Cervical Cancer"
    ),
    (
        "Differentiating Placenta Previa vs Abruptio Placentae",
        [
            "**PP vs PA — Key Differences**",
            "• <b>Pain</b>: PP = Painless | PA = Painful",
            "• <b>Bleeding</b>: PP = Revealed | PA = Concealed/Revealed",
            "• <b>Uterus</b>: PP = Soft | PA = Woody hard (Couvelaire)",
            "• <b>Shock</b>: PP = Proportionate | PA = Disproportionate",
            "• <b>Fetal parts</b>: PP = Palpable | PA = Not palpable",
            "• <b>USG</b>: PP = Placenta over os | PA = Retroplacental clot",
        ],
        "APH"
    ),
    (
        "Causes of DIC in obstetrics — mnemonic",
        [
            "**DIC in Obstetrics — 'PAST DEAD'**",
            "• <b>P</b>re-eclampsia / HELLP",
            "• <b>A</b>bruption placentae",
            "• <b>S</b>epsis (chorioamnionitis)",
            "• <b>T</b>ransfusion reaction",
            "• <b>D</b>ead fetus retained (IUFD)",
            "• <b>E</b>mbolism (amniotic fluid)",
            "• <b>A</b>tonic PPH",
            "• <b>D</b>elayed delivery of second twin",
        ],
        "DIC / Coagulopathy"
    ),
    (
        "Ovarian tumour markers — which marker for which tumour?",
        [
            "**Ovarian Tumour Markers**",
            "• CA-125 → Serous cystadenocarcinoma (epithelial)",
            "• AFP (alpha-fetoprotein) → Yolk sac tumour / Endodermal sinus",
            "• β-hCG → Choriocarcinoma / Dysgerminoma",
            "• LDH → Dysgerminoma",
            "• Inhibin → Granulosa cell tumour",
            "• CEA → Mucinous tumour",
            "• CA 19-9 → Mucinous tumour",
        ],
        "Ovarian Tumours"
    ),
    (
        "Krukenberg, Meigs, Pseudo-Meigs — distinguish them",
        [
            "**Ovarian Syndromes**",
            "• <b>Krukenberg</b> — Metastatic to ovary from GI (stomach most common); mucin signet-ring cells",
            "• <b>Meigs syndrome</b> — Ovarian <b>fibroma</b> + ascites + right pleural effusion",
            "• <b>Pseudo-Meigs</b> — Same picture but with other benign tumours (teratoma, fibrothecoma)",
            "",
            "Meigs resolves after tumour removal",
        ],
        "Ovarian Tumours"
    ),
    (
        "FIGO staging of endometrial cancer — surgical stages",
        [
            "**Endometrial Cancer — Surgical FIGO Staging**",
            "• Stage IA — Tumour confined to uterus, <50% myometrial invasion",
            "• Stage IB — ≥50% myometrial invasion",
            "• Stage II — Cervical stromal invasion",
            "• Stage IIIA — Serosa / adnexa",
            "• Stage IIIC — Pelvic (C1) / para-aortic nodes (C2)",
            "• Stage IVB — Distant metastasis",
            "",
            "Postmenopausal bleeding = endometrial Ca until proven otherwise",
        ],
        "Endometrial Cancer"
    ),
    (
        "Contraception Pearl Index — which method is most effective?",
        [
            "**Pearl Index (lower = better)**",
            "• Sterilisation — 0.02–0.5 (most effective)",
            "• Combined OCP — 0.1–0.3",
            "• IUCD (Cu-T) — 0.6–0.8",
            "• POP (mini-pill) — 0.5–1",
            "• Condom — 2–15",
            "• Diaphragm — 6–20",
            "• Rhythm method — 9–25 (least reliable)",
            "",
            "Only condom protects against STIs",
        ],
        "Contraception"
    ),
    (
        "WHO semen analysis reference values (2021)",
        [
            "**Semen Analysis — WHO 2021**",
            "• Volume ≥ 1.4 mL",
            "• Concentration ≥ 16 million/mL",
            "• Total motility ≥ 42%",
            "• Progressive motility ≥ 30%",
            "• Morphology (Kruger) ≥ 4% normal forms",
            "• pH ≥ 7.2",
            "",
            "Azoospermia = complete absence of sperm",
        ],
        "Infertility"
    ),
]

drug_cards = [
    (
        "MgSO₄ in eclampsia — dose, regimen, antidote",
        [
            "**MgSO₄ (Pritchard Regimen)**",
            "• Loading: 4g IV (20% solution over 5 min) + 10g IM (5g each buttock)",
            "• Maintenance: 5g IM every 4 hours",
            "",
            "**Toxicity monitoring:**",
            "• Urine output ≥25 mL/hr",
            "• Respiratory rate ≥16/min",
            "• Patellar reflex present",
            "",
            "**Antidote: Calcium gluconate 1g IV slow push**",
        ],
        "Eclampsia"
    ),
    (
        "Uterotonics in PPH — first line to last resort",
        [
            "**Uterotonics — Ascending Order**",
            "• 1st: <b>Oxytocin</b> 10 IU IM/IV (safest, first-line)",
            "• 2nd: <b>Ergometrine</b> 0.2 mg IM (avoid in HTN)",
            "• 3rd: <b>Syntometrine</b> (Oxytocin + Ergometrine)",
            "• 4th: <b>Carboprost</b> (PGF2α) 250 mcg IM — most potent",
            "       ⚠ Contraindicated in asthma",
            "• 5th: <b>Misoprostol</b> 800–1000 mcg rectal (PGE1)",
            "• <b>Tranexamic acid</b> 1g IV within 3h (antifibrinolytic)",
        ],
        "PPH"
    ),
    (
        "Tocolytics — drugs used to suppress preterm labor",
        [
            "**Tocolytics**",
            "• <b>Nifedipine</b> (CCB) — first-line; 10 mg oral PRN",
            "• <b>Atosiban</b> (oxytocin antagonist) — IV; Europe",
            "• <b>Ritodrine / Terbutaline</b> — β₂ agonists; side effects: tachycardia, pulmonary oedema",
            "• <b>Indomethacin</b> (NSAID/COX inhibitor) — <32 weeks; risk of premature ductus closure",
            "• <b>MgSO₄</b> — neuroprotection (not primary tocolysis)",
            "",
            "Give betamethasone 12 mg IM × 2 if <34 weeks (lung maturity)",
        ],
        "Preterm Labor"
    ),
    (
        "Antihypertensives in pregnancy — which are safe?",
        [
            "**Safe Antihypertensives in Pregnancy**",
            "• <b>Methyldopa</b> — gold standard oral; α₂ agonist",
            "• <b>Labetalol</b> — first-line IV for severe HTN",
            "• <b>Hydralazine</b> — IV vasodilator; alternative to labetalol",
            "• <b>Nifedipine</b> — oral CCB; safe",
            "• <b>Amlodipine</b> — acceptable",
            "",
            "<b>AVOID:</b> ACE inhibitors, ARBs, thiazides",
            "ACEi/ARB → fetal renal dysgenesis, oligohydramnios",
        ],
        "Hypertension"
    ),
    (
        "Methotrexate in ectopic pregnancy — criteria & dose",
        [
            "**MTX for Ectopic — Inclusion Criteria:**",
            "• Haemodynamically stable",
            "• Unruptured ectopic, size <4 cm",
            "• β-hCG <5000 mIU/mL",
            "• No fetal cardiac activity",
            "• No contraindication to MTX (hepatic/renal disease, immunodeficiency)",
            "",
            "**Dose:** 50 mg/m² IM single dose (or multi-dose regimen)",
            "• Monitor β-hCG on days 4 and 7",
            "• Success if β-hCG drops ≥15% between days 4–7",
        ],
        "Ectopic Pregnancy"
    ),
    (
        "Anti-D (Rho-GAM) — when and how much?",
        [
            "**Anti-D Immunoglobulin**",
            "• Dose: <b>300 mcg (1500 IU) IM</b>",
            "• Within 72 hours of delivery / abortion / sensitising event",
            "",
            "**Antenatal prophylaxis:**",
            "• 300 mcg at 28 weeks (and 34 weeks in some protocols)",
            "",
            "**Sensitising events requiring Anti-D:**",
            "• Miscarriage, TOP, ectopic, amniocentesis, CVS, antepartum bleeding, trauma",
            "",
            "Kleihauer-Betke test to quantify FMH if needed",
        ],
        "Rh Isoimmunisation"
    ),
    (
        "Drugs used in PCOS — for each indication",
        [
            "**PCOS Drug Management**",
            "• <b>Ovulation induction:</b> Clomiphene citrate (first-line), Letrozole (better live birth rates)",
            "• <b>Insulin resistance:</b> Metformin 500–2000 mg/day",
            "• <b>Hyperandrogenism/acne:</b> Combined OCP (ethinyl estradiol + CPA or drospirenone)",
            "• <b>Hirsutism:</b> Spironolactone, Finasteride",
            "• <b>Resistant PCOS:</b> LOD (laparoscopic ovarian drilling) or gonadotrophins",
            "",
            "Weight loss 5–10% restores ovulation in many patients",
        ],
        "PCOS"
    ),
    (
        "GnRH agonists vs antagonists — uses in gynaecology",
        [
            "**GnRH Agonists** (Leuprolide, Goserelin, Nafarelin)",
            "• Initial flare → then downregulation",
            "• Uses: Endometriosis, fibroid shrinkage pre-op, IVF downregulation, precocious puberty",
            "• Side effect: Hypoestrogenic (menopausal symptoms, osteoporosis)",
            "",
            "**GnRH Antagonists** (Cetrorelix, Ganirelix)",
            "• Immediate suppression, no flare",
            "• Used in IVF antagonist protocols",
            "",
            "Add-back therapy (oestrogen) prevents bone loss with long-term agonist use",
        ],
        "Endometriosis / IVF"
    ),
    (
        "Danazol — mechanism, uses and side effects",
        [
            "**Danazol**",
            "• <b>Mechanism:</b> Synthetic androgen / antigonadotropin; inhibits LH & FSH surge",
            "• Creates pseudomenopause",
            "",
            "**Uses:**",
            "• Endometriosis (medical treatment)",
            "• DUB / menorrhagia",
            "• Fibrocystic breast disease",
            "• Hereditary angioedema",
            "",
            "<b>Side effects (androgenic):</b>",
            "• Acne, hirsutism, voice change, weight gain, liver toxicity",
            "• Teratogenic — avoid in pregnancy",
        ],
        "Endometriosis"
    ),
    (
        "Emergency contraception — options, timing, mechanism",
        [
            "**Emergency Contraception (EC)**",
            "• <b>Levonorgestrel (LNG)</b> 1.5 mg — within 72 h; delays ovulation",
            "• <b>Ulipristal acetate (UPA)</b> 30 mg — within 120 h; progesterone receptor modulator",
            "• <b>Cu-IUCD</b> — within 5 days; most effective EC (>99%)",
            "• <b>Yuzpe regimen</b> (high-dose OCP) — older, less used",
            "",
            "LNG does NOT affect implantation of fertilised egg",
            "UPA more effective than LNG if BMI >26",
        ],
        "Contraception"
    ),
    (
        "Drugs contraindicated in pregnancy — high-yield list",
        [
            "**Teratogenic Drugs to Avoid**",
            "• <b>ACE inhibitors / ARBs</b> → oligohydramnios, renal dysgenesis (2nd/3rd trimester)",
            "• <b>Warfarin</b> → warfarin embryopathy (1st trimester), ICH",
            "• <b>Tetracyclines</b> → teeth/bone discolouration",
            "• <b>Fluoroquinolones</b> → cartilage damage",
            "• <b>Methotrexate</b> → folic acid antagonist, fetal death",
            "• <b>Thalidomide</b> → phocomelia (limb reduction)",
            "• <b>Valproate</b> → neural tube defects, cognitive impairment",
            "• <b>Carbamazepine</b> → spina bifida",
            "• <b>Isotretinoin</b> → craniofacial defects",
        ],
        "Pharmacology"
    ),
    (
        "Drugs safe to use in breastfeeding",
        [
            "**Safe in Breastfeeding**",
            "• <b>Antibiotics:</b> Amoxicillin, Erythromycin, Cephalosporins",
            "• <b>Antihypertensives:</b> Methyldopa, Labetalol, Nifedipine",
            "• <b>Analgesics:</b> Paracetamol (first choice), Ibuprofen",
            "• <b>Antidiabetics:</b> Insulin (safe), Metformin (acceptable)",
            "• <b>Antidepressants:</b> Sertraline (preferred SSRI)",
            "",
            "<b>Avoid:</b> Tetracyclines, fluoroquinolones, lithium, radioactive iodine, cytotoxics, high-dose aspirin",
        ],
        "Pharmacology"
    ),
    (
        "Oxytocin — mechanism, uses, side effects",
        [
            "**Oxytocin**",
            "• <b>Mechanism:</b> Binds oxytocin receptors on myometrium → uterine contractions",
            "• Released from posterior pituitary",
            "",
            "<b>Uses:</b>",
            "• Induction/augmentation of labor",
            "• Active management of 3rd stage (10 IU IM)",
            "• PPH treatment",
            "",
            "<b>Side effects:</b>",
            "• Water retention (ADH-like effect) → hyponatraemia",
            "• Hypotension (IV bolus)",
            "• Uterine hyperstimulation → fetal distress",
            "• Contraindicated in malpresentation/obstructed labor",
        ],
        "Labor"
    ),
    (
        "Misoprostol — uses in obstetrics and gynaecology",
        [
            "**Misoprostol (PGE₁ analogue)**",
            "• <b>Cervical ripening:</b> 25–50 mcg vaginal/sublingual before induction",
            "• <b>Medical abortion:</b> 800 mcg vaginal (with or after mifepristone)",
            "• <b>PPH:</b> 800–1000 mcg rectal/sublingual",
            "• <b>IUCD insertion:</b> Cervical softening",
            "",
            "<b>Mifepristone + Misoprostol:</b>",
            "• 200 mg mifepristone (anti-progesterone) → 48h → 800 mcg misoprostol",
            "• Used up to 63 days (9 weeks) gestation for medical TOP",
        ],
        "Abortifacient / PPH"
    ),
    (
        "Chemotherapy for gestational trophoblastic neoplasia",
        [
            "**GTN Chemotherapy Regimens**",
            "• <b>Low-risk GTN:</b> Single-agent <b>Methotrexate</b> (IM) or Actinomycin D",
            "• <b>High-risk GTN:</b> <b>EMA-CO</b> regimen",
            "  → Etoposide, Methotrexate, Actinomycin D / Cyclophosphamide, Oncovin (vincristine)",
            "",
            "<b>FIGO scoring:</b> ≤6 = low risk | ≥7 = high risk",
            "",
            "Choriocarcinoma is the most chemosensitive solid tumour",
            "Even metastatic disease is curable in majority",
        ],
        "GTD / Chemotherapy"
    ),
]


# ── build document ────────────────────────────────────────────────────────────
elements = []

# Cover
elements += cover()
elements.append(PageBreak())

# Legend
legend = Table([
    [
        Paragraph('<font color="#2980B9">🧠 Blue border = Mnemonic card</font>', a_style),
        Paragraph('<font color="#E67E22">💊 Orange border = Drug card</font>', a_style),
    ]
], colWidths=[8.5*cm, 8.5*cm])
legend.setStyle(TableStyle([
    ("BACKGROUND", (0,0), (-1,-1), colors.HexColor("#F8F8F8")),
    ("BOX", (0,0), (-1,-1), 1, colors.grey),
    ("TOPPADDING", (0,0), (-1,-1), 8),
    ("BOTTOMPADDING", (0,0), (-1,-1), 8),
    ("LEFTPADDING", (0,0), (-1,-1), 10),
]))
elements.append(legend)
elements.append(Spacer(1, 0.5*cm))

# Section 1 — Mnemonics
elements += section_banner("SECTION 1: OBG Mnemonics", f"{len(mnemonic_cards)} flashcards")
elements.append(Spacer(1, 0.2*cm))

for i, (q, ans, cat) in enumerate(mnemonic_cards, 1):
    elements.append(flashcard(i, cat, q, ans, card_type="mnemonic"))

elements.append(PageBreak())

# Section 2 — Drugs
elements += section_banner("SECTION 2: OBG Drugs", f"{len(drug_cards)} flashcards")
elements.append(Spacer(1, 0.2*cm))

for i, (q, ans, cat) in enumerate(drug_cards, 1):
    elements.append(flashcard(i, cat, q, ans, card_type="drug"))

# Build
doc.build(elements)
print(f"PDF created: {OUTPUT}")

cd /home/daytona/workspace/fmge-obg-flashcards && python3 make_flashcards.py 2>&…

ls -lh /home/daytona/workspace/fmge-obg-flashcards/FMGE_OBG_Flashcards.pdf