from reportlab.lib.pagesizes import A4
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.units import cm
from reportlab.platypus import SimpleDocTemplate, Paragraph, Spacer, PageBreak, ListFlowable, ListItem
from reportlab.lib import colors

output_path = '/home/daytona/workspace/srb-surgery-notes/MBBS_Surgery_Notes_SRB_Style.pdf'

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

styles = getSampleStyleSheet()
styles.add(ParagraphStyle(name='MainTitle', parent=styles['Title'], fontSize=20, spaceAfter=16, textColor=colors.darkblue))
styles.add(ParagraphStyle(name='H1', parent=styles['Heading1'], fontSize=15, spaceBefore=10, spaceAfter=8, textColor=colors.darkred))
styles.add(ParagraphStyle(name='H2', parent=styles['Heading2'], fontSize=12, spaceBefore=8, spaceAfter=6))
styles.add(ParagraphStyle(name='Body', parent=styles['BodyText'], fontSize=10, leading=14, spaceAfter=4))
styles.add(ParagraphStyle(name='Small', parent=styles['BodyText'], fontSize=8, textColor=colors.grey))

story = []

story.append(Paragraph('Comprehensive MBBS Surgery Notes (SRB-Oriented Exam Notes)', styles['MainTitle']))
story.append(Paragraph('Structured high-yield notes for undergraduate university examinations', styles['Body']))
story.append(Spacer(1, 8))
story.append(Paragraph('Coverage: Wounds, infections, hernia, breast, thyroid, GI, hepatobiliary, pancreas, vascular, urology, trauma, burns, and common viva points.', styles['Body']))
story.append(Paragraph('Primary references mapped to available surgery textbooks in the medical library (Schwartz, Sabiston, Current Surgical Therapy, Greenfield).', styles['Small']))
story.append(PageBreak())

def add_section(title, bullets):
    story.append(Paragraph(title, styles['H1']))
    items = [ListItem(Paragraph(b, styles['Body']), leftIndent=8) for b in bullets]
    story.append(ListFlowable(items, bulletType='bullet', leftIndent=16))
    story.append(Spacer(1, 6))

# 1. General principles
add_section('1. Wound Healing and Tissue Repair', [
    '<b>Phases:</b> Hemostasis/inflammation -> proliferation (granulation, angiogenesis, fibroplasia, epithelialization) -> maturation/remodeling.',
    '<b>Inflammatory phase:</b> neutrophils early, macrophages key regulator via cytokines and growth factors.',
    '<b>Proliferative phase:</b> fibroblasts produce collagen type III initially; angiogenesis gives red granular appearance.',
    '<b>Maturation:</b> collagen cross-linking and conversion toward type I; tensile strength rises gradually (never reaches 100%).',
    '<b>Primary, secondary, tertiary intention</b> must be differentiated in long-answer answers.',
    '<b>Factors delaying healing:</b> infection, ischemia, diabetes, malnutrition, anemia, steroids, radiation, foreign body, edema.',
    '<b>Chronic wound concept:</b> persistent inflammation, biofilm, poor perfusion, repeated trauma/pressure.'
])

add_section('2. Surgical Site Infection (SSI) and Sepsis Basics', [
    'CDC wound classes: clean, clean-contaminated, contaminated, dirty.',
    'Common organisms vary with site: skin flora in clean surgery, gram-negative/anaerobes in GI surgery.',
    'Risk factors: diabetes, obesity, smoking, prolonged surgery, poor asepsis, contamination.',
    'SSI management: open wound if needed, drain pus, debridement, culture-guided antibiotics, optimize glycemic/nutritional status.',
    'Sepsis definitions: suspected infection + organ dysfunction (SOFA-based approach).',
    'Early sepsis bundle: blood cultures, broad-spectrum antibiotics, lactate, IV crystalloids, source control.'
])

add_section('3. Fluids, Electrolytes, Nutrition in Surgical Patients', [
    'Maintenance fluid planning should include daily water + Na/K requirements with clinical reassessment.',
    'Resuscitation in shock: balanced crystalloids preferred initially; assess perfusion endpoints.',
    'Electrolyte issues: hyponatremia, hypokalemia, hyperkalemia, metabolic acidosis/alkalosis are common viva topics.',
    'Nutrition: enteral preferred when gut functional; parenteral when enteral contraindicated or inadequate.',
    'Markers of malnutrition and catabolic stress should be identified preoperatively.'
])

# 2. Hernia
add_section('4. Hernia and Abdominal Wall', [
    '<b>Inguinal hernia:</b> indirect (lateral to inferior epigastric vessels), direct (medial within Hesselbach triangle).',
    '<b>Femoral hernia:</b> below inguinal ligament, higher strangulation risk, more common in females.',
    '<b>Definitions:</b> reducible, irreducible, obstructed, strangulated, incarcerated.',
    'Clinical signs: expansile cough impulse, reducibility, deep ring occlusion test (classic exam style).',
    'Management principle: mesh-based tension-free repair in most adults unless contamination/contraindication.',
    'Laparoscopic options (TEP/TAPP) vs open Lichtenstein: indications, contraindications, complications.',
    'Complications: recurrence, chronic groin pain, seroma, mesh infection, testicular complications.'
])

# 3. Breast and endocrine
add_section('5. Breast Surgery', [
    'Triple assessment in breast lump: clinical examination + imaging + pathological diagnosis.',
    'Benign disorders: fibroadenoma, fibrocystic changes, mastalgia, breast abscess.',
    'Breast cancer risk factors: age, family history/BRCA, hormonal-reproductive factors, obesity.',
    'TNM staging and receptor profile (ER/PR/HER2) guide treatment.',
    'Surgery options: breast-conserving surgery + radiotherapy vs mastectomy in selected cases.',
    'Axilla: sentinel lymph node biopsy in clinically node-negative disease; axillary dissection for selected node-positive cases.',
    'Neoadjuvant and adjuvant systemic therapy principles should be included in long answers.'
])

add_section('6. Thyroid and Parathyroid Surgery', [
    'Evaluate thyroid swelling by thyroid function, ultrasound, and FNAC (Bethesda framework).',
    'Indications for surgery: malignancy/suspicion, compressive symptoms, toxic nodular disease in selected patients.',
    'Types of thyroidectomy: hemithyroidectomy, near-total/total thyroidectomy.',
    'Complications: recurrent laryngeal nerve injury, external branch superior laryngeal nerve injury, hypocalcemia/hypoparathyroidism, hemorrhage.',
    'Post-op neck hematoma causing airway compromise is a surgical emergency.',
    'Primary hyperparathyroidism: localization + focused exploration in selected patients.'
])

# 4. GI
add_section('7. Esophagus, Stomach, Duodenum', [
    'Dysphagia approach: mechanical vs motility causes; alarm symptoms mandate endoscopy.',
    'GERD/hiatus hernia complications: esophagitis, stricture, Barrett change.',
    'Peptic ulcer disease: H. pylori and NSAID are major causes; surgery now mainly for complications.',
    'Complications of PUD: hemorrhage, perforation, gastric outlet obstruction.',
    'Carcinoma stomach: risk factors, Lauren classification concept, staging laparoscopy in advanced disease.',
    'Principles of gastrectomy and lymphadenectomy should be known at MBBS level.'
])

add_section('8. Small Intestine, Appendix, Colon, Rectum, Anal Canal', [
    'Intestinal obstruction: pain, vomiting, distension, constipation; classify as small vs large bowel, simple vs strangulating.',
    'Strangulation clues: tachycardia, fever, localized tenderness, leukocytosis, metabolic acidosis.',
    'Appendicitis: migratory pain to right iliac fossa, anorexia, nausea, fever; Alvarado framework may be mentioned.',
    'Colorectal cancer: right vs left sided presentation differences, staging and multimodality treatment concept.',
    'Acute diverticulitis, volvulus, intussusception are important short notes.',
    'Hemorrhoids, fissure, fistula-in-ano: definitions, clinical differences, and procedural options.',
    'Rectal bleeding approach in exam: stabilize, localize source, investigate with proctoscopy/colonoscopy as indicated.'
])

# 5. Hepatobiliary-pancreas-spleen
add_section('9. Liver, Gallbladder, Bile Duct, Pancreas, Spleen', [
    'Obstructive jaundice causes: stones, malignancy (head pancreas, cholangiocarcinoma), strictures.',
    'Gallstone disease: biliary colic, acute cholecystitis, choledocholithiasis, gallstone pancreatitis.',
    'Acute cholecystitis management: antibiotics + early laparoscopic cholecystectomy in suitable patients.',
    'Acute pancreatitis severity stratification and supportive care are core exam topics.',
    'Complications of pancreatitis: necrosis, pseudocyst, organ failure, infection.',
    'Liver trauma and splenic trauma: nonoperative vs operative principles based on hemodynamic status.',
    'Portal hypertension basics: varices, splenomegaly, ascites, and broad management principles.'
])

# 6. Vascular, urology, trauma
add_section('10. Vascular Surgery Essentials', [
    'Peripheral arterial disease: intermittent claudication, critical limb ischemia, ABI interpretation.',
    'Acute limb ischemia: 6 Ps (pain, pallor, pulselessness, paresthesia, paralysis, poikilothermia).',
    'DVT risk, prophylaxis, and pulmonary embolism prevention are very high-yield.',
    'Varicose veins: CEAP concept, conservative care, endovenous/surgical options.',
    'Aneurysm basics: abdominal aortic aneurysm screening and rupture emergency concept.'
])

add_section('11. Urology for General Surgery Exams', [
    'Urinary retention causes and catheterization principles.',
    'Renal/ureteric stones: presentation, imaging approach, and broad treatment options.',
    'BPH vs prostate cancer clinical distinction and basic management pathways.',
    'Hematuria evaluation should always rule out malignancy in older patients.'
])

add_section('12. Trauma and Burns', [
    'ATLS approach: primary survey (ABCDE) then secondary survey.',
    'Hemorrhagic shock classes and damage-control resuscitation principles.',
    'Head injury basics: GCS, danger signs, indications for urgent neuroimaging referral.',
    'Burn depth and TBSA assessment (Rule of Nines/Lund-Browder).',
    'Initial burn fluid resuscitation concept (e.g., Parkland framework) and urine output targets.',
    'Escharotomy indications, infection prevention, and nutritional support in major burns.'
])

add_section('13. Preoperative and Postoperative Care', [
    'Pre-op optimization: comorbidities, anemia, glycemic control, anticoagulants/antiplatelets, consent.',
    'VTE prophylaxis, antibiotic prophylaxis timing, and WHO safety checklist reduce morbidity.',
    'Post-op fever causes by timeline (wind, water, wound, walking, wonder drugs approach as memory aid).',
    'Common post-op complications: atelectasis, pneumonia, DVT/PE, ileus, SSI, anastomotic leak.'
])

add_section('14. Frequently Asked MBBS Viva and Long-Answer Prompts', [
    'Classify wounds and explain phases of healing.',
    'Differentiate direct and indirect inguinal hernia.',
    'Discuss management of carcinoma breast in a 45-year-old female.',
    'Approach to solitary thyroid nodule.',
    'Clinical features and management of intestinal obstruction.',
    'Short note: acute appendicitis.',
    'Short note: obstructive jaundice.',
    'Short note: acute pancreatitis.',
    'Enumerate causes of postoperative fever and management outline.',
    'Describe primary survey in polytrauma.'
])

add_section('15. Exam Writing Strategy (High Yield)', [
    'Start with definition and classification.',
    'Then etiology/pathogenesis.',
    'Add clinical features in symptom-sign-investigation sequence.',
    'Write management under resuscitation, definitive treatment, complications, follow-up.',
    'Use flowcharts and headings; underline keywords to improve evaluator readability.',
    'Always mention at least 2-3 complications and their prevention in long answers.'
])

story.append(Spacer(1, 10))
story.append(Paragraph('Reference base used from medical library surgery texts: Schwartz\'s Principles of Surgery (11e), Sabiston Textbook of Surgery, Current Surgical Therapy, Greenfield\'s Surgery.', styles['Small']))
story.append(Paragraph('Note: These are exam-oriented condensed notes for MBBS study and revision, not a replacement for full textbook reading.', styles['Small']))

doc.build(story)
print(output_path)