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I'm a Medical student

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Anatomy, physiology, biochemistry
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Just ask me anything — whether it's a concept you're trying to understand, a drug mechanism, a clinical scenario, or exam prep. What are you studying right now?

Do you know marrow platform for neet pg.Have you any ideas about it?

Yes, I'm familiar with Marrow! It's one of the most popular platforms among Indian medical students preparing for NEET PG (and NEXT). Here's a quick overview:

🩺 Marrow Platform

What it is: A comprehensive online prep platform specifically designed for NEET PG / NEXT exams, built by doctors for doctors.

Key Features:

Video lectures by top faculty (many are well-known exam toppers/teachers)
Qbank — large question bank with detailed explanations
Flashcards & Rapid Revision modules
Grand Tests & Subject Tests — mock exams with All India ranking
MARROW Notes — concise, high-yield study notes
Performance analytics — tracks weak areas

Popular for:

High-yield, exam-focused teaching style
Regularly updated content aligned with recent exam patterns
Strong community of NEET PG aspirants

Plans: They offer different subscription tiers (Silver, Gold, Platinum, etc.) covering different subjects and durations.

How I can complement Marrow for you:

Deep-dive explanations on topics you find confusing
Help with pharmacology, pathology, medicine concepts
Clarify mechanisms, mnemonics, clinical correlations
Summarize recent evidence when needed

Are you currently using Marrow? What subjects or topics are you focusing on right now?

Can you please provide me Q bank of it?

I'm not able to provide Marrow's Qbank content. Here's why:

Marrow's question bank is proprietary, paid content protected by copyright
Sharing it would be illegal (piracy) and a violation of their terms of service
I don't have access to their platform's database

What I can do for you instead:

Practice questions I can generate:

I can create NEET PG-style MCQs on any topic you're studying — anatomy, pharmacology, pathology, medicine, surgery, etc.
Questions with detailed explanations, just like a real Qbank

Example: Just say something like:

"Give me 10 MCQs on cardiac pharmacology" "Quiz me on renal pathology" "NEET PG questions on CNS drugs"

Other free resources:

DAMS free questions — free sample questions
NBCE / Recall questions — community-shared recall Qs
Previous year NEET PG papers (legally available online)

Would you like me to generate some practice MCQs on a topic you're currently studying? Just name the subject! 🎯

Generate 10 NEET PG MCQs on a specific topicRHD

Reading File

Finding Sources

Reading File

Now I have rich, textbook-sourced content to generate high-quality, accurate NEET PG-style MCQs on RHD. Let me compile them:

🩺 10 NEET PG MCQs — Rheumatic Heart Disease (RHD)

Q1. Rheumatic fever (RF) is an immunologically mediated disease triggered by infection with which organism?

A) Staphylococcus aureus
B) Group A Streptococcus (S. pyogenes)
C) Group B Streptococcus
D) Streptococcus pneumoniae

✅ Answer & Explanation

Answer: B — Group A Streptococcus (S. pyogenes)

RF follows Group A streptococcal pharyngitis (2–3 weeks later). Molecular mimicry between streptococcal M proteins and cardiac antigens (cross-reactive antibodies and T cells) causes tissue damage. Importantly, streptococci are absent from the lesions themselves.

— Robbins Pathologic Basis of Disease

Q2. The pathognomonic histological lesion of acute rheumatic carditis is:

A) Anitschkow cells in Aschoff bodies
B) Lambl's excrescences
C) Verocay bodies
D) Russell bodies

✅ Answer & Explanation

Answer: A — Anitschkow cells in Aschoff bodies

Aschoff bodies are focal inflammatory lesions containing T lymphocytes, plasma cells, and Anitschkow cells (plump macrophages with central nuclei where chromatin condenses into a wavy ribbon — called "caterpillar cells"). They are pathognomonic of rheumatic carditis.

— Robbins Pathologic Basis of Disease

Q3. RHD is virtually the ONLY cause of which valvular lesion?

A) Aortic regurgitation
B) Tricuspid stenosis
C) Mitral stenosis
D) Pulmonary stenosis

✅ Answer & Explanation

Answer: C — Mitral stenosis

RHD is characterized principally by deforming fibrotic valvular disease, particularly the mitral valve. RHD is virtually the only cause of mitral stenosis. The mitral valve is affected in isolation in ~2/3 of cases, and along with the aortic valve in another ~25%.

— Robbins Pathologic Basis of Disease

Q4. In the Revised Jones Criteria (2015), which of the following is a MAJOR criterion for diagnosing acute rheumatic fever in HIGH-RISK populations but NOT in low-risk populations?

A) Carditis
B) Monoarthritis
C) Chorea
D) Subcutaneous nodules

✅ Answer & Explanation

Answer: B — Monoarthritis

In high-risk populations, monoarticular arthritis qualifies as a major criterion. In low-risk populations, only polyarticular arthritis is a major criterion (monoarthralgia is only a minor criterion). Carditis, chorea, erythema marginatum, and subcutaneous nodules are major criteria in both populations.

— Goldman-Cecil Medicine

Q5. Small vegetations (1–2 mm) seen along the line of closure of valves in acute rheumatic fever are called:

A) MacCallum plaques
B) Verrucae
C) Libman-Sacks vegetations
D) Janeway lesions

✅ Answer & Explanation

Answer: B — Verrucae

In acute RF, fibrinoid necrosis in valve cusps is overlaid by small (1–2 mm) vegetations called verrucae along the lines of closure. MacCallum plaques are subendocardial thickenings in the left atrium caused by regurgitant jets.

— Robbins Pathologic Basis of Disease

Q6. The "fish mouth" appearance of the mitral valve on gross examination is characteristic of:

A) Mitral valve prolapse
B) Infective endocarditis
C) Chronic rheumatic mitral stenosis
D) Calcific aortic stenosis

✅ Answer & Explanation

Answer: C — Chronic rheumatic mitral stenosis

Calcification and fibrous bridging across valvular commissures in chronic RHD create "fish mouth" stenoses of the mitral valve. This is a classic morphological feature tested repeatedly in NEET PG.

— Robbins Pathologic Basis of Disease

Q7. Secondary prophylaxis in rheumatic fever to prevent recurrence is best achieved with:

A) Oral amoxicillin daily
B) IM benzathine penicillin G 1.2 million units every 4 weeks
C) IV vancomycin monthly
D) Oral erythromycin twice daily

✅ Answer & Explanation

Answer: B — IM benzathine penicillin G 1.2 million units every 4 weeks

This is the drug of choice for secondary prophylaxis in RF, recommended for a minimum of 10 years (and in some cases indefinitely). It eradicates residual Group A streptococcus and prevents recurrent attacks, which cause cumulative valve damage.

— Goldman-Cecil Medicine

Q8. In acute rheumatic fever, Sydenham's chorea (St. Vitus' dance) is caused by:

A) Immune complex deposition in joints
B) Antibody binding to basal ganglia
C) T-cell infiltration of the myocardium
D) Delayed hypersensitivity in the skin

✅ Answer & Explanation

Answer: B — Antibody binding to basal ganglia

The various manifestations of RF have distinct immunopathological mechanisms:

Carditis → antibody-binding + T-cell infiltration
Arthritis → immune complexes in joints
Chorea → antibody binding to basal ganglia
Skin lesions → delayed hypersensitivity

— Goldman-Cecil Medicine

Q9. The most common valve affected in chronic RHD, in ISOLATION, is:

A) Aortic valve
B) Tricuspid valve
C) Mitral valve
D) Pulmonary valve

✅ Answer & Explanation

Answer: C — Mitral valve

The mitral valve is virtually always involved in chronic RHD — in isolation in ~2/3 of cases, and together with the aortic valve in ~25%. Tricuspid involvement is infrequent; pulmonary valve is only rarely affected.

— Robbins Pathologic Basis of Disease

Q10. A 12-year-old child presents 3 weeks after sore throat with fever, migratory large-joint polyarthritis, and a new pansystolic murmur. ESR is 70 mm/hr and PR interval is prolonged on ECG. According to Revised Jones Criteria, how many MAJOR criteria does this patient fulfill?

A) 1
B) 2
C) 3
D) 4

✅ Answer & Explanation

Answer: B — 2 Major criteria

Major criteria present:

Carditis (new murmur = valvulitis)
Polyarthritis (migratory large-joint)

Minor criteria present:

Fever ≥38.5°C
Elevated ESR (≥60 mm in low-risk; ≥30 mm in high-risk)
Prolonged PR interval (Note: PR interval is NOT counted as a minor criterion when carditis is already a major criterion)

Diagnosis of initial ARF = 2 major OR 1 major + 2 minor criteria → This child satisfies diagnosis with 2 major criteria.

— Goldman-Cecil Medicine

📊 Quick Summary Table

Topic	High-Yield Fact
Causative agent	Group A Streptococcus
Mechanism	Molecular mimicry (M protein ↔ cardiac antigens)
Pathognomonic lesion	Aschoff bodies with Anitschkow (caterpillar) cells
Only cause of mitral stenosis	RHD
Valve most commonly affected alone	Mitral (2/3 cases)
Chorea mechanism	Antibody → basal ganglia
Vegetations in acute RF	Verrucae (1–2 mm, along line of closure)
"Fish mouth" valve	Chronic rheumatic mitral stenosis
Secondary prophylaxis	IM Benzathine Penicillin G q4 weeks
Jones criteria (initial ARF)	2 major OR 1 major + 2 minor

Want MCQs on a specific subtopic of RHD (e.g., mitral stenosis management, Jones criteria edge cases, valvular surgery)? Or shall I move to another topic?

Generate a 5-slide presentation on RHD pathology

Reading File

Searching Images

rheumatic heart disease mitral stenosis pathology Aschoff body

Running Command

ls -la /home/daytona/workspace/ 2>/dev/null || mkdir -p /home/daytona/workspace

Running Command

mkdir -p /home/daytona/workspace/rhd-presentation && node /home/daytona/skills/shared/scripts/fetch_images.js \ "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_1926864c377809b8f90fd3942de5bb4b4dd1d9aef38712369a74447c4a2aa246.jpg" \ "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_ea16062e5420e91b4df2e1edfb4e9089d0967c440825bb4080f632ba864c997a.jpg" \ "https://cdn.orris.care/cdss_images/547a22ca533dfb26ca0dc4c88359a9f4ab225f52a652e79a1fd49e2a1d070af6.png" \ "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_da1a81044fab6514e92ea85316a22141f6ba83664ec1c5ff98890d5995d9e82f.jpg" 2>/dev/null | node -e " const d = JSON.parse(require('fs').readFileSync('/dev/stdin','utf8')); d.forEach((x,i)=>console.log(i, x.error ? 'ERROR:'+x.error : 'OK len='+x.base64.length)); "

Writing File

~/rhd-presentation/create_rhd_pptx.js

const pptxgen = require("pptxgenjs");
const { execSync } = require("child_process");

// Fetch images
const imageUrls = [
  "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_1926864c377809b8f90fd3942de5bb4b4dd1d9aef38712369a74447c4a2aa246.jpg",  // Fish-mouth gross
  "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_ea16062e5420e91b4df2e1edfb4e9089d0967c440825bb4080f632ba864c997a.jpg",  // Echo mitral
  "https://cdn.orris.care/cdss_images/pmc_clinical_VQA_da1a81044fab6514e92ea85316a22141f6ba83664ec1c5ff98890d5995d9e82f.jpg",  // Echo PLAX
];

const images = JSON.parse(
  execSync(
    `node /home/daytona/skills/shared/scripts/fetch_images.js ${imageUrls.map(u => `"${u}"`).join(" ")}`
  ).toString()
);

const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title = "Rheumatic Heart Disease — Pathology";
pres.author = "Orris Medical";

// ── COLOR PALETTE ──────────────────────────────────────────────────
const C = {
  darkBg:    "0D1B2A",   // deep navy — dominant
  midBg:     "1B2E45",   // slightly lighter navy for panels
  accent:    "C0392B",   // deep red (blood/cardiac theme)
  accentAlt: "E74C3C",   // lighter red for highlights
  gold:      "F1C40F",   // gold accent for key facts
  white:     "FFFFFF",
  offWhite:  "EAF0FB",
  lightGray: "BDC3C7",
  textMuted: "94A3B8",
};

// ╔══════════════════════════════════════════════════════════╗
// ║  SLIDE 1 — TITLE SLIDE                                   ║
// ╚══════════════════════════════════════════════════════════╝
{
  const s = pres.addSlide();

  // Full background
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.darkBg }, line: { color: C.darkBg } });

  // Left accent bar
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 0.18, h: 5.625, fill: { color: C.accent }, line: { color: C.accent } });

  // Red top stripe
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.07, fill: { color: C.accent }, line: { color: C.accent } });

  // Heart icon area — decorative circle
  s.addShape(pres.shapes.ELLIPSE, {
    x: 6.8, y: 0.6, w: 2.6, h: 2.6,
    fill: { color: C.accent, transparency: 85 },
    line: { color: C.accentAlt, width: 1.5 }
  });

  // Heart symbol (text)
  s.addText("♥", { x: 7.1, y: 0.8, w: 2, h: 2, fontSize: 72, color: C.accent, align: "center", valign: "middle", transparency: 30 });

  // Title
  s.addText("Rheumatic Heart Disease", {
    x: 0.4, y: 1.1, w: 6.2, h: 1.1,
    fontSize: 36, bold: true, color: C.white,
    fontFace: "Calibri", align: "left", valign: "middle"
  });

  // Subtitle
  s.addText("Pathology, Pathogenesis & Morphology", {
    x: 0.4, y: 2.25, w: 6, h: 0.55,
    fontSize: 18, color: C.accentAlt,
    fontFace: "Calibri", align: "left", italic: true
  });

  // Divider line
  s.addShape(pres.shapes.RECTANGLE, {
    x: 0.4, y: 2.9, w: 5.8, h: 0.04,
    fill: { color: C.accent }, line: { color: C.accent }
  });

  // Tags row
  const tags = ["Cardiology", "Pathology", "NEET PG"];
  tags.forEach((tag, i) => {
    s.addShape(pres.shapes.ROUNDED_RECTANGLE, {
      x: 0.4 + i * 1.85, y: 3.1, w: 1.65, h: 0.38,
      fill: { color: C.midBg }, line: { color: C.accentAlt, width: 1 }, rectRadius: 0.06
    });
    s.addText(tag, {
      x: 0.4 + i * 1.85, y: 3.1, w: 1.65, h: 0.38,
      fontSize: 11, color: C.accentAlt, align: "center", valign: "middle", bold: true
    });
  });

  // Source
  s.addText("Source: Robbins Pathologic Basis of Disease · Goldman-Cecil Medicine", {
    x: 0.4, y: 4.95, w: 9.2, h: 0.3,
    fontSize: 9, color: C.textMuted, align: "left"
  });
}

// ╔══════════════════════════════════════════════════════════╗
// ║  SLIDE 2 — ETIOLOGY & PATHOGENESIS                       ║
// ╚══════════════════════════════════════════════════════════╝
{
  const s = pres.addSlide();
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.darkBg }, line: { color: C.darkBg } });
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.07, fill: { color: C.accent }, line: { color: C.accent } });

  // Slide heading bar
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0.07, w: 10, h: 0.75, fill: { color: C.midBg }, line: { color: C.midBg } });
  s.addText("ETIOLOGY & PATHOGENESIS", {
    x: 0.35, y: 0.07, w: 9.3, h: 0.75,
    fontSize: 20, bold: true, color: C.white, fontFace: "Calibri", align: "left", valign: "middle", charSpacing: 2
  });
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0.07, w: 0.18, h: 0.75, fill: { color: C.accent }, line: { color: C.accent } });

  // Step boxes — pathogenesis flow
  const steps = [
    { label: "1", title: "Trigger", body: "Group A Streptococcal\npharyngitis (GAS)" },
    { label: "2", title: "Delay", body: "2–3 week latent period\n(immune response generation)" },
    { label: "3", title: "Mimicry", body: "Cross-reactive antibodies\nagainst M proteins ↔ cardiac antigens" },
    { label: "4", title: "Carditis", body: "Ab + T-cell mediated\ninflammation of heart" },
    { label: "5", title: "Chronic RHD", body: "Scarring, fibrosis\nof heart valves" },
  ];

  steps.forEach((step, i) => {
    const x = 0.2 + i * 1.94;
    // Box
    s.addShape(pres.shapes.RECTANGLE, {
      x, y: 1.05, w: 1.75, h: 3.5,
      fill: { color: i === 4 ? C.accent : C.midBg },
      line: { color: i === 4 ? C.accentAlt : C.accentAlt, width: 1 },
      shadow: { type: "outer", color: "000000", blur: 8, offset: 3, angle: 135, opacity: 0.2 }
    });
    // Number circle
    s.addShape(pres.shapes.ELLIPSE, {
      x: x + 0.55, y: 1.15, w: 0.65, h: 0.65,
      fill: { color: i === 4 ? C.white : C.accent },
      line: { color: i === 4 ? C.accent : C.accent }
    });
    s.addText(step.label, {
      x: x + 0.55, y: 1.15, w: 0.65, h: 0.65,
      fontSize: 16, bold: true, color: i === 4 ? C.accent : C.white,
      align: "center", valign: "middle"
    });
    // Title
    s.addText(step.title, {
      x: x + 0.08, y: 2.0, w: 1.6, h: 0.5,
      fontSize: 13, bold: true, color: C.gold,
      align: "center", valign: "middle"
    });
    // Body
    s.addText(step.body, {
      x: x + 0.08, y: 2.55, w: 1.6, h: 1.7,
      fontSize: 10.5, color: C.offWhite,
      align: "center", valign: "top"
    });

    // Arrow between boxes
    if (i < 4) {
      s.addShape(pres.shapes.RECTANGLE, {
        x: x + 1.78, y: 2.65, w: 0.12, h: 0.06,
        fill: { color: C.accentAlt }, line: { color: C.accentAlt }
      });
    }
  });

  // Key note at bottom
  s.addShape(pres.shapes.RECTANGLE, { x: 0.2, y: 4.75, w: 9.6, h: 0.6, fill: { color: C.midBg }, line: { color: C.textMuted, width: 0.5 } });
  s.addText("⚠  Streptococci are ABSENT from lesions — damage is purely immunological (molecular mimicry). Genetic susceptibility required (only 0.3–3% of GAS infections progress to RF).", {
    x: 0.35, y: 4.75, w: 9.3, h: 0.6,
    fontSize: 10, color: C.gold, align: "left", valign: "middle", italic: true
  });
}

// ╔══════════════════════════════════════════════════════════╗
// ║  SLIDE 3 — MORPHOLOGY: ACUTE RF                          ║
// ╚══════════════════════════════════════════════════════════╝
{
  const s = pres.addSlide();
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.darkBg }, line: { color: C.darkBg } });
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.07, fill: { color: C.accent }, line: { color: C.accent } });

  // Heading
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0.07, w: 10, h: 0.75, fill: { color: C.midBg }, line: { color: C.midBg } });
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0.07, w: 0.18, h: 0.75, fill: { color: C.accent }, line: { color: C.accent } });
  s.addText("MORPHOLOGY — ACUTE RHEUMATIC FEVER", {
    x: 0.35, y: 0.07, w: 9.3, h: 0.75,
    fontSize: 20, bold: true, color: C.white, fontFace: "Calibri", align: "left", valign: "middle", charSpacing: 2
  });

  // LEFT panel — Aschoff bodies
  s.addShape(pres.shapes.RECTANGLE, {
    x: 0.2, y: 1.0, w: 4.5, h: 4.3,
    fill: { color: C.midBg }, line: { color: C.accentAlt, width: 1 },
    shadow: { type: "outer", color: "000000", blur: 8, offset: 3, angle: 135, opacity: 0.2 }
  });

  s.addText("ASCHOFF BODIES", {
    x: 0.35, y: 1.1, w: 4.2, h: 0.45,
    fontSize: 14, bold: true, color: C.gold, align: "left"
  });

  s.addText([
    { text: "Pathognomonic", options: { bold: true, color: C.accentAlt, breakLine: true } },
    { text: " lesion of acute RF\n", options: { color: C.offWhite, breakLine: false } },
    { text: "\n• Foci of ", options: { color: C.offWhite } },
    { text: "T lymphocytes", options: { bold: true, color: C.gold } },
    { text: " + plasma cells\n", options: { color: C.offWhite } },
    { text: "• ", options: { color: C.offWhite } },
    { text: "Anitschkow cells", options: { bold: true, color: C.gold } },
    { text: " (activated macrophages)\n", options: { color: C.offWhite } },
    { text: '  – "Caterpillar cells"\n', options: { color: C.textMuted, italic: true } },
    { text: "  – Wavy chromatin ribbon in nucleus\n", options: { color: C.textMuted } },
    { text: "\n• Affect ALL 3 layers → ", options: { color: C.offWhite } },
    { text: "PANCARDITIS\n", options: { bold: true, color: C.accentAlt } },
    { text: "  – Pericarditis\n", options: { color: C.offWhite } },
    { text: "  – Myocarditis\n", options: { color: C.offWhite } },
    { text: "  – Endocarditis (most significant)\n", options: { color: C.offWhite } },
    { text: "\n• Small verrucae (1–2 mm vegetations)\n", options: { color: C.offWhite } },
    { text: "  along valve line of closure\n", options: { color: C.textMuted } },
    { text: "\n• ", options: { color: C.offWhite } },
    { text: "MacCallum plaques", options: { bold: true, color: C.gold } },
    { text: " — LA subendocardium", options: { color: C.offWhite } },
  ], {
    x: 0.35, y: 1.6, w: 4.2, h: 2.9,
    fontSize: 11, color: C.offWhite, valign: "top"
  });

  // RIGHT panel — Valves involved
  s.addShape(pres.shapes.RECTANGLE, {
    x: 5.1, y: 1.0, w: 4.7, h: 4.3,
    fill: { color: C.midBg }, line: { color: C.accentAlt, width: 1 },
    shadow: { type: "outer", color: "000000", blur: 8, offset: 3, angle: 135, opacity: 0.2 }
  });

  s.addText("VALVE INVOLVEMENT IN ACUTE RF", {
    x: 5.25, y: 1.1, w: 4.4, h: 0.45,
    fontSize: 13, bold: true, color: C.gold, align: "left"
  });

  const valveData = [
    { valve: "Mitral", freq: "Most common — isolated 2/3 cases", pct: 100 },
    { valve: "Mitral + Aortic", freq: "Combined — ~25% of cases", pct: 65 },
    { valve: "Tricuspid", freq: "Infrequent", pct: 20 },
    { valve: "Pulmonary", freq: "Rarely affected", pct: 5 },
  ];

  valveData.forEach((v, i) => {
    const y = 1.7 + i * 0.85;
    s.addText(v.valve, { x: 5.25, y, w: 1.7, h: 0.35, fontSize: 12, bold: true, color: C.accentAlt });
    s.addShape(pres.shapes.RECTANGLE, {
      x: 5.25, y: y + 0.38, w: 4.3 * v.pct / 100, h: 0.22,
      fill: { color: i === 0 ? C.accent : C.midBg.replace("1B2E45", "2C4A6E") },
      line: { color: C.accentAlt }
    });
    s.addShape(pres.shapes.RECTANGLE, {
      x: 5.25, y: y + 0.38, w: 4.3, h: 0.22,
      fill: { color: "FFFFFF", transparency: 95 },
      line: { color: C.textMuted, width: 0.5 }
    });
    s.addShape(pres.shapes.RECTANGLE, {
      x: 5.25, y: y + 0.38, w: 4.3 * v.pct / 100, h: 0.22,
      fill: { color: i === 0 ? C.accent : "2C5282" },
      line: { color: i === 0 ? C.accentAlt : "4299E1" }
    });
    s.addText(v.freq, { x: 5.25, y: y + 0.62, w: 4.3, h: 0.2, fontSize: 9.5, color: C.textMuted });
  });
}

// ╔══════════════════════════════════════════════════════════╗
// ║  SLIDE 4 — MORPHOLOGY: CHRONIC RHD + IMAGES             ║
// ╚══════════════════════════════════════════════════════════╝
{
  const s = pres.addSlide();
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.darkBg }, line: { color: C.darkBg } });
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.07, fill: { color: C.accent }, line: { color: C.accent } });

  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0.07, w: 10, h: 0.75, fill: { color: C.midBg }, line: { color: C.midBg } });
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0.07, w: 0.18, h: 0.75, fill: { color: C.accent }, line: { color: C.accent } });
  s.addText("CHRONIC RHD — MITRAL STENOSIS", {
    x: 0.35, y: 0.07, w: 9.3, h: 0.75,
    fontSize: 20, bold: true, color: C.white, fontFace: "Calibri", align: "left", valign: "middle", charSpacing: 2
  });

  // Left — text bullet points
  s.addShape(pres.shapes.RECTANGLE, {
    x: 0.2, y: 1.0, w: 4.6, h: 4.3,
    fill: { color: C.midBg }, line: { color: C.accentAlt, width: 1 }
  });

  s.addText("Cardinal Anatomic Changes", {
    x: 0.35, y: 1.1, w: 4.3, h: 0.4,
    fontSize: 13, bold: true, color: C.gold
  });

  s.addText([
    { text: "• Leaflet thickening\n", options: { breakLine: false } },
    { text: "• Commissural fusion & shortening\n", options: {} },
    { text: "• Thickening & fusion of chordae\n", options: {} },
    { text: "\n" },
    { text: '"Fish-mouth" / "Buttonhole" stenosis\n', options: { bold: true, color: C.accentAlt } },
    { text: "  Calcification + fibrous bridging\n", options: { color: C.textMuted } },
    { text: "\n" },
    { text: "Downstream consequences:\n", options: { bold: true, color: C.gold } },
    { text: "• Left atrium dilatation\n", options: {} },
    { text: "• Mural thrombi → embolism risk\n", options: {} },
    { text: "• Pulmonary hypertension\n", options: {} },
    { text: "• Right ventricular hypertrophy\n", options: {} },
    { text: "\n" },
    { text: "Neovascularization ", options: { bold: true, color: C.accentAlt } },
    { text: "of mitral leaflet\n", options: {} },
    { text: "(hallmark of chronicity)", options: { italic: true, color: C.textMuted } },
  ], {
    x: 0.35, y: 1.6, w: 4.3, h: 3.55,
    fontSize: 11.5, color: C.offWhite, valign: "top"
  });

  // Right — gross pathology image
  if (images[0] && !images[0].error) {
    s.addShape(pres.shapes.RECTANGLE, {
      x: 5.1, y: 1.0, w: 4.7, h: 2.85,
      fill: { color: "000000" }, line: { color: C.accentAlt, width: 1.5 }
    });
    s.addImage({
      data: images[0].base64,
      x: 5.1, y: 1.0, w: 4.7, h: 2.85,
    });
    s.addShape(pres.shapes.RECTANGLE, {
      x: 5.1, y: 3.72, w: 4.7, h: 0.55,
      fill: { color: "000000", transparency: 40 }, line: { color: C.accentAlt }
    });
    s.addText('Gross specimen: "Fish-mouth" mitral stenosis — RHD', {
      x: 5.1, y: 3.72, w: 4.7, h: 0.55,
      fontSize: 9.5, color: C.white, align: "center", valign: "middle", italic: true
    });
  }

  // Echo image below
  if (images[2] && !images[2].error) {
    s.addShape(pres.shapes.RECTANGLE, {
      x: 5.1, y: 4.35, w: 4.7, h: 0.95,
      fill: { color: C.midBg }, line: { color: C.accentAlt, width: 1 }
    });
    s.addText("Echo (PLAX): Anterior leaflet 'hockey-stick' doming, restricted diastolic opening — hallmark of rheumatic mitral stenosis.", {
      x: 5.2, y: 4.38, w: 4.5, h: 0.85,
      fontSize: 9.5, color: C.textMuted, valign: "middle", italic: true
    });
  }
}

// ╔══════════════════════════════════════════════════════════╗
// ║  SLIDE 5 — JONES CRITERIA & KEY SUMMARY                  ║
// ╚══════════════════════════════════════════════════════════╝
{
  const s = pres.addSlide();
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.darkBg }, line: { color: C.darkBg } });
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0, w: 10, h: 0.07, fill: { color: C.accent }, line: { color: C.accent } });

  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0.07, w: 10, h: 0.75, fill: { color: C.midBg }, line: { color: C.midBg } });
  s.addShape(pres.shapes.RECTANGLE, { x: 0, y: 0.07, w: 0.18, h: 0.75, fill: { color: C.accent }, line: { color: C.accent } });
  s.addText("DIAGNOSIS — REVISED JONES CRITERIA (2015)", {
    x: 0.35, y: 0.07, w: 9.3, h: 0.75,
    fontSize: 20, bold: true, color: C.white, fontFace: "Calibri", align: "left", valign: "middle", charSpacing: 2
  });

  // MAJOR criteria panel
  s.addShape(pres.shapes.RECTANGLE, {
    x: 0.2, y: 1.0, w: 4.6, h: 3.7,
    fill: { color: C.midBg }, line: { color: C.accentAlt, width: 1.5 }
  });
  s.addShape(pres.shapes.RECTANGLE, {
    x: 0.2, y: 1.0, w: 4.6, h: 0.5,
    fill: { color: C.accent }, line: { color: C.accent }
  });
  s.addText("MAJOR CRITERIA", {
    x: 0.2, y: 1.0, w: 4.6, h: 0.5,
    fontSize: 13, bold: true, color: C.white, align: "center", valign: "middle"
  });

  const majors = [
    ["Carditis", "Clinical + subclinical (echo) valvulitis"],
    ["Arthritis", "Polyarticular (low risk) / Monoarticular (high risk)"],
    ["Chorea", "Sydenham chorea (St. Vitus dance)"],
    ["Erythema marginatum", "Pink, serpiginous macules — trunk & limbs"],
    ["Subcutaneous nodules", "Painless, over bony prominences"],
  ];

  majors.forEach(([title, desc], i) => {
    const y = 1.6 + i * 0.58;
    s.addShape(pres.shapes.ELLIPSE, { x: 0.3, y: y + 0.05, w: 0.28, h: 0.28, fill: { color: C.accent }, line: { color: C.accentAlt } });
    s.addText(title, { x: 0.65, y, w: 3.6, h: 0.28, fontSize: 11.5, bold: true, color: C.gold });
    s.addText(desc, { x: 0.65, y: y + 0.28, w: 4.0, h: 0.26, fontSize: 9.5, color: C.textMuted });
  });

  // MINOR criteria panel
  s.addShape(pres.shapes.RECTANGLE, {
    x: 5.2, y: 1.0, w: 4.6, h: 2.5,
    fill: { color: C.midBg }, line: { color: C.textMuted, width: 1 }
  });
  s.addShape(pres.shapes.RECTANGLE, {
    x: 5.2, y: 1.0, w: 4.6, h: 0.5,
    fill: { color: "2C5282" }, line: { color: "2C5282" }
  });
  s.addText("MINOR CRITERIA", {
    x: 5.2, y: 1.0, w: 4.6, h: 0.5,
    fontSize: 13, bold: true, color: C.white, align: "center", valign: "middle"
  });

  s.addText([
    { text: "• Fever ≥38.5°C\n", options: { breakLine: false } },
    { text: "• Elevated ESR / CRP\n", options: {} },
    { text: "  (ESR ≥60 mm [low risk] / ≥30 mm [high risk])\n", options: { color: C.textMuted, italic: true } },
    { text: "• Prolonged PR interval (if carditis not already major)\n", options: {} },
    { text: "• Polyarthralgia (low risk) / Monoarthralgia (high risk)\n", options: {} },
  ], {
    x: 5.35, y: 1.6, w: 4.3, h: 1.75,
    fontSize: 11, color: C.offWhite, valign: "top"
  });

  // Diagnosis rule box
  s.addShape(pres.shapes.RECTANGLE, {
    x: 5.2, y: 3.6, w: 4.6, h: 1.1,
    fill: { color: C.accent, transparency: 15 }, line: { color: C.accentAlt, width: 1.5 }
  });
  s.addText("Diagnosis of Initial ARF", {
    x: 5.35, y: 3.65, w: 4.3, h: 0.35,
    fontSize: 12, bold: true, color: C.white
  });
  s.addText("2 Major  OR  1 Major + 2 Minor criteria\n+ Evidence of preceding GAS infection", {
    x: 5.35, y: 4.0, w: 4.3, h: 0.62,
    fontSize: 11, color: C.gold
  });

  // Prophylaxis footer
  s.addShape(pres.shapes.RECTANGLE, { x: 0.2, y: 4.85, w: 9.6, h: 0.55, fill: { color: C.midBg }, line: { color: C.textMuted, width: 0.5 } });
  s.addText("Secondary Prophylaxis:  IM Benzathine Penicillin G 1.2 MU every 4 weeks  ≥10 years (or indefinitely if persistent cardiac involvement)", {
    x: 0.35, y: 4.85, w: 9.3, h: 0.55,
    fontSize: 10, color: C.gold, align: "left", valign: "middle", bold: false, italic: true
  });
}

// Save
pres.writeFile({ fileName: "/home/daytona/workspace/rhd-presentation/RHD_Pathology.pptx" })
  .then(() => console.log("✅ Saved: RHD_Pathology.pptx"))
  .catch(e => console.error("❌", e));

Running Command

cd /home/daytona/workspace/rhd-presentation && node create_rhd_pptx.js 2>&1

Running Command

node -e "const p = require('pptxgenjs'); const pres = new p(); console.log(JSON.stringify(Object.keys(pres.shapes).slice(0,30)))"

Running Command

node -e "const p = require('pptxgenjs'); const pres = new p(); const keys = Object.keys(pres.shapes); console.log(keys.filter(k => ['RECTANGLE','ELLIPSE','ROUNDED'].some(s => k.includes(s))))"

Running Command

node -e "const p = require('pptxgenjs'); const pres = new p(); const keys = Object.keys(pres.shapes); console.log(keys.filter(k => k.includes('OVAL') || k.includes('CIRCLE') || k.includes('ELLIP')))"

Running Command

sed -i 's/pres\.shapes\.ELLIPSE/pres.shapes.OVAL/g' /home/daytona/workspace/rhd-presentation/create_rhd_pptx.js && cd /home/daytona/workspace/rhd-presentation && node create_rhd_pptx.js 2>&1

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Make a printable PDF summary of RHD pathology

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Any pyqs in RHD in Neet pg

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