ls /tmp/workspace/ 2>/dev/null || mkdir -p /tmp/workspace/anatomy-topics

mkdir -p /tmp/workspace/anatomy-topics && python3 << 'EOF' # First, let's figure out which topics to keep # ALL 50 topics: all_topics = { 1: "Scalp injury causes black eye.", 2: "A boil on tip of nose may cause inflammation of cavernous sinus.", 3: "A more proximal ulnar nerve injury (near elbow) can result in less clawing of the hand compared to a more distal injury (at wrist).", 4: "Brachial artery used for measuring blood pressure at cubital fossa.", 5: "A vasovagal attack can be triggered by ear cleaning.", 6: "Prostate cancer frequently metastasizes to the vertebrae.", 7: "Periumbilical pain.", 8: "Gastric ulcer more commonly found along the lesser curvature of stomach.", 9: "Fibula more commonly used for bone grafting.", 10: "Saphenous vein commonly used for CABG.", 11: "Profuse bleeding can occur in case of injury of anterior part of medial nasal septum.", 12: "Carpal tunnel syndrome.", 13: "Thyroid swelling moves with deglutition.", 14: "Black eye.", 15: "Winging of scapula.", 16: "Recurrent dislocation of shoulder joint.", 17: "Why Varicocele is more common on left side?", 18: "Explain embryological basis of omphalocele?", 19: "Why do pregnant women have predominantly thoracic type of respiration?", 20: "Outer quadrant of gluteal region is commonly used sites for intramuscular injection.", 21: "Explain why fluid gets accumulated in Pouch of Douglas in ambulatory patients?", 22: "Explain why foot drop occurs in case of fracture neck of fibula?", 23: "Why do the inhaled foreign body tend to pass into the right lobe of lung?", 24: "Why the Soleus muscle is known as peripheral heart?", 25: "Why femoral hernia is more common in females?", 26: "Why the pain of appendicitis felt at the umbilicus?", 27: "Why Varicoceles are more common on the left side of the body?", 28: "Why the pain of hip joint is felt at the knee?", 29: "Why maxillary sinus is prone to infection?", 30: "Why formation of calculi more common in submandibular gland as compared to parotid gland?", 31: "Why there is wrist drop in injury of radial nerve?", 32: "Why are the tips of nose and finger red in extreme winters?", 33: "Why do the injuries of scalp bleed profusely?", 34: "Why there is partial Ptosis in Horner's syndrome.", 35: "Caput medusa is seen at umbilicus.", 36: "Femoral hernia is more common in females than males.", 37: "Thorax is circular (Transverse section) in children while it is kidney shaped (Transverse section) in adults.", 38: "Referred pain of Gall bladder is felt at the tip of Right shoulder.", 39: "Varicocele is more common on left side.", 40: "Perineal body tear may lead to prolapse of pelvic organs?", 41: "'Carrying Angle' is more in females then males.", 42: "Little's area is a common site of epistaxis.", 43: "Bleeding from tonsillar fossa after tonsillectomy.", 44: "Different forms of cleft palate formation.", 45: "Anatomical basis for spread of Breast carcinoma.", 46: "Varicocele common on left side.", 47: "Pain over tip of right shoulder in cholecystitis.", 48: "Hip joint is more stable then shoulder joint.", 49: "Twinning in Pregnancy.", 50: "Great saphenous vein commonly involved in varicosity.", } # Topics to REMOVE: # Upper Limb: 3, 4, 12, 15, 16, 31, 41 (carrying angle - elbow) # Head/Neck/Face: 1, 2, 5, 11, 13, 14, 29, 30, 33, 42, 43, 44 # Neuroanatomy: 34 (Horner's syndrome - autonomic/neuroanatomy) # Also 32 "tips of nose AND finger" - partially head/face, partially upper limb -> remove remove_ids = { # Upper Limb 3, 4, 12, 15, 16, 31, 41, 32, # Head/Neck/Face 1, 2, 5, 11, 13, 14, 29, 30, 33, 42, 43, 44, # Neuroanatomy 34 } kept = [(k, v) for k, v in all_topics.items() if k not in remove_ids] print(f"Kept {len(kept)} topics:") for i, (orig, text) in enumerate(kept, 1): print(f" {i}. (orig {orig}) {text}") EOF

python3 << 'PYEOF' from PIL import Image, ImageDraw, ImageFont import textwrap import os # Canvas size - portrait format similar to original W, H = 900, 1350 img = Image.new("RGB", (W, H), (255, 255, 255)) draw = ImageDraw.Draw(img) # ── Colors ────────────────────────────────────────────────────────────────── DARK_BLUE = (10, 36, 99) ROYAL_BLUE = (26, 82, 195) YELLOW_HL = (255, 210, 0) LIGHT_BG = (240, 245, 255) CIRCLE_BG = (26, 82, 195) TEXT_DARK = (20, 30, 60) WHITE = (255, 255, 255) FOOTER_BG = (10, 36, 99) BORDER_CLR = (180, 200, 240) # ── Header background ──────────────────────────────────────────────────────── draw.rectangle([0, 0, W, 160], fill=DARK_BLUE) # "50" large text try: font_huge = ImageFont.truetype("/usr/share/fonts/truetype/dejavu/DejaVuSans-Bold.ttf", 100) font_large = ImageFont.truetype("/usr/share/fonts/truetype/dejavu/DejaVuSans-Bold.ttf", 38) font_med = ImageFont.truetype("/usr/share/fonts/truetype/dejavu/DejaVuSans-Bold.ttf", 28) font_small = ImageFont.truetype("/usr/share/fonts/truetype/dejavu/DejaVuSans.ttf", 18) font_bold = ImageFont.truetype("/usr/share/fonts/truetype/dejavu/DejaVuSans-Bold.ttf", 18) font_tiny = ImageFont.truetype("/usr/share/fonts/truetype/dejavu/DejaVuSans.ttf", 14) font_tiny_b= ImageFont.truetype("/usr/share/fonts/truetype/dejavu/DejaVuSans-Bold.ttf", 14) font_num = ImageFont.truetype("/usr/share/fonts/truetype/dejavu/DejaVuSans-Bold.ttf", 15) font_item = ImageFont.truetype("/usr/share/fonts/truetype/dejavu/DejaVuSans.ttf", 15) except: font_huge = font_large = font_med = font_small = font_bold = font_tiny = font_tiny_b = font_num = font_item = ImageFont.load_default() # Draw "29" (updated count) draw.text((30, 10), "29", font=font_huge, fill=YELLOW_HL) # "WHY &" and "SHORT ESSAY" draw.text((175, 18), "WHY &", font=font_large, fill=WHITE) draw.text((175, 65), "SHORT ESSAY", font=font_large, fill=YELLOW_HL) # Subheader bar draw.rectangle([0, 118, W, 158], fill=ROYAL_BLUE) draw.text((30, 128), "HIGH-YIELD TOPICS | ANATOMY", font=font_med, fill=WHITE) # Remove notice strip draw.rectangle([0, 158, W, 185], fill=(230, 240, 255)) draw.text((15, 163), "Remaining after removing: Upper Limb | Head, Neck & Face | Neuroanatomy", font=font_tiny, fill=ROYAL_BLUE) # ── Topics ─────────────────────────────────────────────────────────────────── topics = [ "Prostate cancer frequently metastasizes to the vertebrae.", "Periumbilical pain.", "Gastric ulcer more commonly found along the lesser curvature of stomach.", "Fibula more commonly used for bone grafting.", "Saphenous vein commonly used for CABG.", "Why Varicocele is more common on left side?", "Explain embryological basis of omphalocele?", "Why do pregnant women have predominantly thoracic type of respiration?", "Outer quadrant of gluteal region is commonly used sites for intramuscular injection.", "Explain why fluid gets accumulated in Pouch of Douglas in ambulatory patients?", "Explain why foot drop occurs in case of fracture neck of fibula?", "Why do the inhaled foreign body tend to pass into the right lobe of lung?", "Why the Soleus muscle is known as peripheral heart?", "Why femoral hernia is more common in females?", "Why the pain of appendicitis felt at the umbilicus?", "Why Varicoceles are more common on the left side of the body?", "Why the pain of hip joint is felt at the knee?", "Caput medusa is seen at umbilicus.", "Femoral hernia is more common in females than males.", "Thorax is circular (Transverse section) in children while it is kidney shaped (Transverse section) in adults.", "Referred pain of Gall bladder is felt at the tip of Right shoulder.", "Varicocele is more common on left side.", "Perineal body tear may lead to prolapse of pelvic organs?", "Anatomical basis for spread of Breast carcinoma.", "Varicocele common on left side.", "Pain over tip of right shoulder in cholecystitis.", "Hip joint is more stable then shoulder joint.", "Twinning in Pregnancy.", "Great saphenous vein commonly involved in varicosity.", ] # Two-column layout col_w = (W - 30) // 2 # each column width col1_x = 10 col2_x = col_w + 20 y_start = 198 line_h = 20 # base line height pad = 4 # padding between items CIRC_R = 11 # circle radius # Split into two roughly equal columns half = (len(topics) + 1) // 2 # 15 in col1, 14 in col2 def draw_item(draw, num, text, x, y, col_w, font_num, font_item, circ_r): """Draw a numbered item with circle bullet. Returns new y.""" max_text_w = col_w - circ_r*2 - 20 # Wrap text avg_char_w = 8 wrap_chars = max_text_w // avg_char_w lines = textwrap.wrap(text, width=wrap_chars) if not lines: lines = [text] item_h = len(lines) * line_h + pad # Circle cx = x + circ_r cy = y + circ_r + 2 draw.ellipse([cx - circ_r, cy - circ_r, cx + circ_r, cy + circ_r], fill=CIRCLE_BG) # Number in circle num_str = str(num) bbox = draw.textbbox((0,0), num_str, font=font_num) nw = bbox[2] - bbox[0] nh = bbox[3] - bbox[1] draw.text((cx - nw//2, cy - nh//2 - 1), num_str, font=font_num, fill=WHITE) # Text lines tx = x + circ_r*2 + 8 ty = y + 2 for line in lines: draw.text((tx, ty), line, font=font_item, fill=TEXT_DARK) ty += line_h return y + item_h + 2 # Draw light background for content area draw.rectangle([0, y_start - 5, W, H - 70], fill=LIGHT_BG) # Column 1 y1 = y_start for i, topic in enumerate(topics[:half], 1): y1 = draw_item(draw, i, topic, col1_x, y1, col_w, font_num, font_item, CIRC_R) # Column 2 y2 = y_start for i, topic in enumerate(topics[half:], half + 1): y2 = draw_item(draw, i, topic, col2_x, y2, col_w, font_num, font_item, CIRC_R) # Divider line between columns draw.line([col_w + 15, y_start - 5, col_w + 15, max(y1, y2) + 5], fill=BORDER_CLR, width=1) # ── Footer ─────────────────────────────────────────────────────────────────── footer_y = H - 65 draw.rectangle([0, footer_y, W, H - 35], fill=FOOTER_BG) draw.text((20, footer_y + 8), "★ HIGH-YIELD FOR UC EXAMS", font=font_tiny_b, fill=YELLOW_HL) draw.text((310, footer_y + 8), "🎯 STUDY SMART, SCORE HIGH", font=font_tiny_b, fill=WHITE) draw.text((620, footer_y + 8), "📖 RUHS MBBS", font=font_tiny_b, fill=WHITE) draw.rectangle([0, H - 35, W, H], fill=(5, 20, 60)) draw.text((20, H - 27), "t.me/ruhs_mbbs", font=font_tiny, fill=(150, 200, 255)) draw.text((W//2 - 100, H - 27), "RUHS MBBS – Your Exam Partner", font=font_tiny_b, fill=WHITE) draw.text((W - 120, H - 27), "@ruhs_mbbs", font=font_tiny, fill=(150, 200, 255)) out_path = "/tmp/workspace/anatomy-topics/29_high_yield_anatomy.png" img.save(out_path, quality=95) print(f"Saved: {out_path}") print(f"Image size: {img.size}") PYEOF

python3 -c " from PIL import Image img = Image.open('/tmp/workspace/anatomy-topics/29_high_yield_anatomy.png') print('Mode:', img.mode) print('Size:', img.size) print('Format:', img.format) " && ls -lh /tmp/workspace/anatomy-topics/

ls /tmp/workspace/ && mkdir -p /tmp/workspace/ruhs-anatomy-pdf

python3 << 'PYEOF' from reportlab.lib.pagesizes import A4 from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle from reportlab.lib.units import cm from reportlab.lib import colors from reportlab.platypus import (SimpleDocTemplate, Paragraph, Spacer, HRFlowable, Table, TableStyle, KeepTogether) from reportlab.lib.enums import TA_LEFT, TA_CENTER, TA_JUSTIFY from reportlab.platypus import PageBreak OUTPUT = "/tmp/workspace/ruhs-anatomy-pdf/RUHS_Anatomy_29_High_Yield_QA.pdf" # ── Page setup ──────────────────────────────────────────────────────────────── doc = SimpleDocTemplate( OUTPUT, pagesize=A4, leftMargin=2*cm, rightMargin=2*cm, topMargin=2.2*cm, bottomMargin=2.2*cm, title="RUHS Anatomy – 29 High-Yield Why & Short Essay Answers", author="RUHS MBBS", ) W, H = A4 # ── Colors ──────────────────────────────────────────────────────────────────── DARK_BLUE = colors.HexColor("#0A2463") ROYAL_BLUE = colors.HexColor("#1A52C3") GOLD = colors.HexColor("#FFD200") LIGHT_BG = colors.HexColor("#EDF2FF") TEAL = colors.HexColor("#0D7377") RED_ACCENT = colors.HexColor("#C0392B") MID_GRAY = colors.HexColor("#555555") VERY_LIGHT = colors.HexColor("#F5F8FF") # ── Styles ──────────────────────────────────────────────────────────────────── styles = getSampleStyleSheet() cover_title = ParagraphStyle("cover_title", fontSize=26, leading=32, textColor=colors.white, fontName="Helvetica-Bold", alignment=TA_CENTER, spaceAfter=6) cover_sub = ParagraphStyle("cover_sub", fontSize=14, leading=18, textColor=GOLD, fontName="Helvetica-Bold", alignment=TA_CENTER, spaceAfter=4) cover_info = ParagraphStyle("cover_info", fontSize=11, leading=16, textColor=colors.white, fontName="Helvetica", alignment=TA_CENTER, spaceAfter=3) q_style = ParagraphStyle("q_style", fontSize=12, leading=16, textColor=colors.white, fontName="Helvetica-Bold", alignment=TA_LEFT, leftIndent=4, spaceAfter=0, spaceBefore=0) section_head = ParagraphStyle("section_head", fontSize=10, leading=13, textColor=ROYAL_BLUE, fontName="Helvetica-Bold", alignment=TA_LEFT, spaceBefore=6, spaceAfter=2) body_bold = ParagraphStyle("body_bold", fontSize=10, leading=14, textColor=DARK_BLUE, fontName="Helvetica-Bold", alignment=TA_JUSTIFY, spaceBefore=0, spaceAfter=1) body = ParagraphStyle("body", fontSize=10, leading=14, textColor=colors.HexColor("#222222"), fontName="Helvetica", alignment=TA_JUSTIFY, spaceBefore=0, spaceAfter=1) bullet_style = ParagraphStyle("bullet_style", fontSize=10, leading=14, textColor=colors.HexColor("#222222"), fontName="Helvetica", alignment=TA_JUSTIFY, leftIndent=14, bulletIndent=4, spaceBefore=1, spaceAfter=1) takeaway_style = ParagraphStyle("takeaway_style", fontSize=10, leading=14, textColor=TEAL, fontName="Helvetica-BoldOblique", alignment=TA_JUSTIFY, spaceBefore=2, spaceAfter=2) note_style = ParagraphStyle("note_style", fontSize=9, leading=12, textColor=MID_GRAY, fontName="Helvetica-Oblique", alignment=TA_CENTER, spaceBefore=2, spaceAfter=2) story = [] # ══════════════════════════════════════════════════════════════════════════════ # COVER PAGE # ══════════════════════════════════════════════════════════════════════════════ def cover_page(canvas, doc): canvas.saveState() # Dark blue background canvas.setFillColor(DARK_BLUE) canvas.rect(0, 0, W, H, fill=1, stroke=0) # Gold accent bar top canvas.setFillColor(GOLD) canvas.rect(0, H - 1.2*cm, W, 1.2*cm, fill=1, stroke=0) # Gold accent bar bottom canvas.rect(0, 0, W, 1.0*cm, fill=1, stroke=0) # Side accent stripe canvas.setFillColor(ROYAL_BLUE) canvas.rect(0, 0, 0.7*cm, H, fill=1, stroke=0) canvas.rect(W - 0.7*cm, 0, 0.7*cm, H, fill=1, stroke=0) canvas.restoreState() # ── Cover content ───────────────────────────────────────────────────────────── story.append(Spacer(1, 3*cm)) story.append(Paragraph("RUHS MBBS", cover_sub)) story.append(Spacer(1, 0.4*cm)) story.append(Paragraph("29 High-Yield", cover_title)) story.append(Paragraph("WHY &amp; SHORT ESSAY", ParagraphStyle("ct2", fontSize=30, leading=36, textColor=GOLD, fontName="Helvetica-Bold", alignment=TA_CENTER, spaceAfter=6))) story.append(Paragraph("ANATOMY ANSWERS", cover_title)) story.append(Spacer(1, 0.8*cm)) # Divider story.append(HRFlowable(width="70%", thickness=2, color=GOLD, hAlign='CENTER')) story.append(Spacer(1, 0.6*cm)) story.append(Paragraph("1st Year MBBS · Rajasthan University of Health Sciences", cover_info)) story.append(Spacer(1, 0.3*cm)) story.append(Paragraph("Topics remaining after removing:", cover_info)) story.append(Paragraph( "<font color='#FFD200'><b>Upper Limb | Head, Neck &amp; Face | Neuroanatomy</b></font>", ParagraphStyle("ci2", fontSize=12, leading=16, textColor=GOLD, fontName="Helvetica-Bold", alignment=TA_CENTER, spaceAfter=4))) story.append(Spacer(1, 1*cm)) story.append(HRFlowable(width="70%", thickness=1, color=colors.white, hAlign='CENTER')) story.append(Spacer(1, 0.6*cm)) story.append(Paragraph("3-Mark Structured Answers", cover_info)) story.append(Paragraph("Core Rationale · Detailed Mechanism · Clinical Takeaway", cover_info)) story.append(Spacer(1, 3*cm)) story.append(Paragraph("Study Smart, Score High", ParagraphStyle("tag", fontSize=13, leading=16, textColor=GOLD, fontName="Helvetica-BoldOblique", alignment=TA_CENTER))) story.append(PageBreak()) # ══════════════════════════════════════════════════════════════════════════════ # HELPER: build one Q&A block # ══════════════════════════════════════════════════════════════════════════════ def qa_block(num, question, core_text, bullets, takeaway, note=None): """Returns a KeepTogether-wrapped list of flowables for one Q&A.""" elems = [] # Question header band q_data = [[Paragraph(f"Q{num}. {question}", q_style)]] q_table = Table(q_data, colWidths=[W - 4*cm]) q_table.setStyle(TableStyle([ ('BACKGROUND', (0,0), (-1,-1), ROYAL_BLUE), ('TOPPADDING', (0,0), (-1,-1), 7), ('BOTTOMPADDING', (0,0), (-1,-1), 7), ('LEFTPADDING', (0,0), (-1,-1), 10), ('RIGHTPADDING', (0,0), (-1,-1), 10), ('ROUNDEDCORNERS', [5]), ])) elems.append(q_table) elems.append(Spacer(1, 0.25*cm)) # Core Rationale elems.append(Paragraph("🔷 Core Rationale", section_head)) elems.append(Paragraph(core_text, body)) elems.append(Spacer(1, 0.15*cm)) # Detailed Breakdown elems.append(Paragraph("🔹 Detailed Anatomical / Physiological Basis", section_head)) for b in bullets: elems.append(Paragraph(f"• {b}", bullet_style)) elems.append(Spacer(1, 0.15*cm)) # Clinical Takeaway elems.append(Paragraph("✅ Clinical Takeaway", section_head)) elems.append(Paragraph(takeaway, takeaway_style)) if note: elems.append(Paragraph(f"📝 {note}", note_style)) elems.append(HRFlowable(width="100%", thickness=0.5, color=colors.HexColor("#CCCCCC"), spaceAfter=8)) elems.append(Spacer(1, 0.2*cm)) return KeepTogether(elems) # ══════════════════════════════════════════════════════════════════════════════ # ALL 29 Q&A DATA # ══════════════════════════════════════════════════════════════════════════════ qa_data = [ (1, "Prostate cancer frequently metastasizes to the vertebrae.", "Prostate cancer spreads to vertebrae via <b>Batson's valveless vertebral venous plexus</b>, " "a low-pressure venous network providing a direct route from pelvic organs to the axial skeleton.", [ "<b>Batson's plexus</b> runs alongside the entire vertebral column, communicating freely with pelvic veins draining the prostate.", "It is <b>valveless</b> — increased intra-abdominal pressure (coughing, straining) reverses flow, pushing tumour emboli into vertebral bodies.", "Vertebral bodies are <b>highly vascular with red marrow</b>, providing a favourable microenvironment for metastatic seeding.", ], "Vertebral metastases from prostate cancer are typically <b>osteoblastic (sclerotic)</b> and are " "the most common cause of pathological vertebral fracture in elderly males."), (2, "Periumbilical pain (referred from midgut organs).", "Periumbilical pain is <b>referred pain</b> from midgut-derived organs (appendix, small intestine, " "proximal colon), whose visceral afferents travel via the <b>lesser splanchnic nerves</b> and enter " "the spinal cord at <b>T10</b> — the same dermatomal level as the umbilicus.", [ "<b>Visceral pain</b> is poorly localised; visceral afferents from T10-innervated organs converge on the same dorsal horn neurons as somatic T10 dermatome skin.", "The <b>appendix, ileum, and ascending colon</b> are all midgut derivatives sharing T10 visceral innervation.", "In <b>acute appendicitis</b>, pain begins periumbilically (visceral phase) and then shifts to McBurney's point once parietal peritoneum is irritated (somatic phase).", ], "Periumbilical pain shifting to the RIF is the hallmark sequence in <b>acute appendicitis</b>, " "reflecting transition from visceral to somatic peritoneal irritation."), (3, "Gastric ulcer is more commonly found along the lesser curvature of the stomach.", "The <b>lesser curvature</b> is the most vulnerable site for peptic ulceration due to relative " "ischaemia, direct acid-pepsin exposure via the gastric canal, and slower mucosal regeneration.", [ "<b>Magenstrasse (gastric canal)</b> runs along the lesser curvature, channelling food and acid directly against this mucosa during every swallow.", "The terminal branches of the left and right gastric arteries meet here, creating a zone of <b>relative ischaemia</b> with slower mucosal repair.", "The <b>incisura angularis</b> (angle of His) marks the body-antrum junction — a common site for Type I (benign) gastric ulcers due to the acid-sensitive transition mucosa.", ], "Gastric ulcers at the lesser curvature that fail to heal <b>must be biopsied</b> to exclude " "malignancy — unlike duodenal ulcers, gastric ulcers carry a small but real risk of carcinomatous change."), (4, "Fibula is more commonly used for bone grafting.", "The fibula is the <b>preferred donor bone for vascularised cortical grafting</b> because it is " "non-weight-bearing, long, straight, has a reliable vascular pedicle (<b>peroneal artery</b>), " "and its harvest causes minimal functional deficit.", [ "The <b>peroneal artery</b> runs closely alongside the fibula, providing endosteal and periosteal blood supply — enabling a <b>free vascularised fibular graft</b> that heals faster than avascular grafts.", "The fibula is <b>expendable</b>: the leg retains full weight-bearing function as long as the proximal 6 cm and distal 8 cm are preserved.", "It can provide up to <b>25 cm of cortical bone</b>, making it ideal for mandibular, long bone, and spinal reconstructions.", ], "Free vascularised fibular grafts are the gold standard for <b>mandibular reconstruction</b> after " "oncological resection and for long-bone defects >6 cm."), (5, "Saphenous vein is commonly used for CABG.", "The <b>great saphenous vein (GSV)</b> is the most commonly harvested conduit for Coronary Artery " "Bypass Grafting due to its accessibility, length, calibre match with coronary arteries, and " "functional expendability.", [ "The GSV runs a <b>constant, superficial, predictable course</b> from the medial malleolus to the saphenofemoral junction, making harvest straightforward.", "Its diameter of <b>3–4 mm</b> closely matches that of coronary arteries, ensuring haemodynamic compatibility.", "The leg has sufficient <b>collateral venous drainage</b> via the deep venous system, so GSV removal does not cause significant venous insufficiency.", ], "Although the internal mammary artery has superior long-term patency, the GSV remains widely used " "for <b>multi-vessel CABG</b>; saphenous neuralgia and leg wound infection are the most common post-harvest complications."), (6, "Varicocele is more common on the left side.", "The <b>left testicular vein</b> drains at a right angle (90°) into the left renal vein rather than " "directly into the IVC, creating higher venous back-pressure and predisposing to valvular " "incompetence and venous dilatation.", [ "<b>Right testicular vein</b> drains obliquely into the IVC — a shorter, lower-resistance route with competent valves.", "<b>Left testicular vein</b> drains perpendicular into the left renal vein at 90°, creating a hydrostatic column effect (<b>nutcracker phenomenon</b>) and higher intraluminal pressure → valve failure.", "The <b>sigmoid colon</b> overlies the left spermatic vein and may further compress it, increasing venous stasis on the left.", ], "A <b>sudden-onset right-sided varicocele</b> in an older male should raise suspicion for a " "retroperitoneal mass or renal cell carcinoma causing IVC obstruction."), (7, "Embryological basis of omphalocele.", "Omphalocele results from <b>failure of the lateral body wall folds to fuse at the umbilical ring</b> " "during weeks 6–10 of development, leaving abdominal viscera herniated into the base of the " "umbilical cord, covered by peritoneum and amnion.", [ "During weeks 6–10, the midgut undergoes <b>physiological herniation</b> into the umbilical cord (rapidly growing gut outpaces abdominal cavity), then normally returns and rotates by week 10.", "In omphalocele, <b>failure of lateral fold fusion</b> means the abdominal wall defect persists and gut fails to return — viscera remain outside.", "Unlike gastroschisis, the herniated viscera are covered by a <b>sac of peritoneum + Wharton's jelly</b> — this sac distinguishes the two conditions.", ], "Omphalocele has a <b>high association with other congenital anomalies</b> (cardiac defects, " "Trisomy 13/18) unlike gastroschisis — prenatal karyotyping is essential."), (8, "Pregnant women have predominantly thoracic type of respiration.", "As the <b>enlarging uterus elevates the diaphragm</b> by up to 4 cm, normal abdominal " "(diaphragmatic) breathing is mechanically restricted, forcing a compensatory shift to " "<b>intercostal (thoracic) breathing</b>.", [ "The uterus progressively displaces abdominal contents upward, <b>compressing and elevating the diaphragm</b>, reducing its excursion range.", "<b>Progesterone</b> increases respiratory drive; to maintain tidal volume, the thoracic cage compensates by expanding the subcostal angle (from 68° → 103°) and increasing thoracic diameter.", "<b>FRC decreases by ~20%</b> due to diaphragmatic elevation, making thoracic rib excursion the dominant respiratory mechanism.", ], "This thoracic shift contributes to the <b>physiological hyperventilation of pregnancy</b> " "(PaCO₂ falls to ~30 mmHg), facilitating fetal CO₂ transfer across the placenta."), (9, "Outer quadrant of gluteal region is commonly used for IM injection.", "The <b>upper outer (superolateral) quadrant</b> of the gluteal region is the safest site for " "intramuscular injection because it avoids the major neurovascular structures, particularly the " "<b>sciatic nerve</b> located in the lower medial quadrant.", [ "The <b>sciatic nerve</b> exits the greater sciatic foramen below piriformis and runs through the lower medial quadrant — injections here risk sciatic nerve palsy.", "The upper outer quadrant overlies the thick <b>gluteus maximus</b>, ensuring true intramuscular drug delivery with a standard needle length.", "The <b>superior gluteal nerve and artery</b> are located medially in the upper gluteal region — the superolateral quadrant avoids them.", ], "The <b>ventrogluteal site</b> (iliac crest triangle — von Hochstetter's site) is now preferred " "as it is even further from the sciatic nerve, has less subcutaneous fat, and carries a lower infection risk."), (10, "Fluid accumulates in the Pouch of Douglas in ambulatory patients.", "The <b>Pouch of Douglas (rectouterine/rectovesical pouch)</b> is the most dependent part of " "the peritoneal cavity in the <b>erect position</b>, so any free peritoneal fluid gravitates here " "under gravity in ambulatory patients.", [ "In females, the pouch lies between the <b>posterior uterus/vaginal fornix and the rectum</b>; in males, between the <b>bladder and rectum</b> — both are the lowest peritoneal recesses in the erect posture.", "In the <b>supine position</b>, fluid redistributes to the <b>hepatorenal pouch (Morrison's pouch)</b>, which becomes the most dependent area.", "The pouch is bounded by peritoneum and has no floor other than the vaginal wall/rectum, allowing accumulation of <b>pus, blood, or ascitic fluid</b>.", ], "Fluid in the pouch of Douglas is detected by <b>posterior vaginal fornix tenderness</b> or " "culdocentesis, and seen on ultrasound as anechoic fluid posteriorly in the pelvis."), (11, "Foot drop occurs in fracture of neck of fibula.", "The <b>common peroneal (fibular) nerve</b> winds closely around the neck of the fibula, making " "it extremely vulnerable to injury here, resulting in paralysis of dorsiflexors and evertors " "of the foot — <b>foot drop</b>.", [ "The common peroneal nerve passes superficially around the <b>neck of the fibula</b>, separated from bone only by a thin fascial layer — it is the most exposed peripheral nerve in the body.", "It divides here into: <b>deep peroneal nerve</b> (dorsiflexion — tibialis anterior, extensor digitorum) and <b>superficial peroneal nerve</b> (eversion — peroneus longus and brevis).", "Damage abolishes dorsiflexion → the patient cannot lift the foot off the ground → <b>steppage gait</b> (high-stepping to avoid toe-dragging).", ], "The common peroneal nerve at the fibular neck is also vulnerable during <b>leg plasters, " "prolonged squatting, or lithotomy position</b> — always pad the fibular neck during prolonged procedures."), (12, "Inhaled foreign body tends to pass into the right lobe of the lung.", "The <b>right main bronchus</b> is wider, shorter, and more vertically oriented than the left, " "forming a smaller angle (~25°) with the tracheal axis — making it the path of least resistance " "for aspirated foreign bodies.", [ "<b>Right main bronchus</b>: length ~2.5 cm, diameter ~1.5 cm, angle ~25° with tracheal midline — a near-straight continuation of the trachea.", "<b>Left main bronchus</b>: length ~5 cm, diameter ~1.3 cm, angle ~45° — requires a more acute directional change, impeding foreign body passage.", "In <b>children especially</b>, the right lower lobe bronchus receives aspirated objects because of this near-vertical geometry.", ], "A foreign body in the right bronchus causes <b>obstructive emphysema (partial)</b> or " "<b>atelectasis (complete obstruction)</b> of the right lower lobe; diagnosed by inspiratory-expiratory CXR or bronchoscopy."), (13, "Soleus muscle is known as the peripheral heart.", "The soleus is called the <b>'peripheral heart'</b> because its powerful rhythmic contractions " "during walking actively compress large venous sinuses within its substance, pumping blood " "from the lower limb back toward the heart against gravity.", [ "The soleus contains <b>large venous sinuses</b> (~100–150 mL capacity) within its substance; contraction compresses these sinuses, propelling venous blood upward through competent valves.", "It is the <b>most powerful venous pump</b> in the lower limb — equivalent to an auxiliary cardiac pump for the venous return from the lower extremity.", "<b>Immobility</b> (bed rest, prolonged sitting) disables the soleus pump → venous stasis in deep calf veins → primary mechanism for DVT formation.", ], "Early ambulation post-surgery is the most effective measure to <b>prevent DVT</b> by reactivating " "the soleus pump; mechanical calf compression devices replicate this effect when ambulation is not possible."), (14, "Femoral hernia is more common in females.", "Femoral hernia is more common in females due to the <b>wider female pelvis (gynecoid)</b>, " "which creates a broader femoral ring and femoral canal — a larger potential space through " "which abdominal contents can herniate.", [ "The <b>femoral ring</b> (bounded by: lacunar ligament medially, femoral vein laterally, inguinal ligament anteriorly, pectineal ligament posteriorly) is wider in females due to the broader pelvic dimensions.", "In the gynecoid pelvis, the wider angle between the inguinal and pectineal ligaments <b>enlarges the femoral ring</b> compared to the narrower male pelvis.", "The femoral canal contains only <b>loose areolar tissue and Cloquet's lymph node</b>, offering little resistance to herniation under raised intra-abdominal pressure.", ], "Despite being more common in females, <b>inguinal hernia remains the most common hernia in women</b> overall. " "Femoral hernias carry a high risk of strangulation (~40%) due to the rigid femoral ring."), (15, "Pain of appendicitis is felt at the umbilicus initially.", "The appendix is a <b>midgut derivative</b> innervated by visceral afferents travelling via " "<b>T10 splanchnic nerves</b>, which converge on dorsal horn neurons also receiving somatic " "input from the T10 dermatome — the umbilical region — producing referred periumbilical pain.", [ "In <b>early appendicitis</b>, only the visceral peritoneum is inflamed — visceral afferents produce poorly localised, colicky, periumbilical pain via the <b>convergence-projection theory</b> of referred pain.", "As inflammation progresses, the <b>parietal peritoneum</b> (somatic innervation via ilioinguinal nerve, T12–L1) is involved → pain localises to the <b>right iliac fossa (McBurney's point)</b>.", "This shift from periumbilical → RIF typically occurs over <b>4–6 hours</b> and is the classic diagnostic sequence of acute appendicitis.", ], "The <b>'periumbilical pain migrating to RIF'</b> is pathognomonic of acute appendicitis; " "failure of this migration should prompt consideration of alternative diagnoses."), (16, "Varicoceles are more common on the left side of the body.", "Same mechanism as Q6 — the <b>left testicular vein drains at 90° into the left renal vein</b>, " "creating hydrostatic pressure and valve incompetence. The right vein drains obliquely into the IVC.", [ "<b>Left testicular vein → left renal vein (90° angle)</b>: high resistance, hydrostatic column, valve failure.", "<b>Right testicular vein → IVC (oblique angle)</b>: lower resistance, shorter course, competent valves.", "Compression by the <b>sigmoid colon</b> on the left spermatic vein further increases venous stasis.", ], "Isolated <b>right-sided varicocele</b> or sudden onset in an older male warrants imaging to " "exclude retroperitoneal malignancy or IVC obstruction.", note="This is a repeat of Q6. Write the same answer in the exam."), (17, "Pain of hip joint is felt at the knee.", "Pain from the hip joint is referred to the knee because the <b>obturator nerve (L2–L4)</b> " "supplies articular branches to both the <b>hip joint and the medial knee joint</b>, creating " "a shared referred pain pathway (Hilton's Law).", [ "The <b>obturator nerve</b> carries articular branches to both the hip joint (posterior branch) and the medial knee (cutaneous branch) — same nerve, two joints.", "<b>Hilton's Law</b>: nerves supplying a joint also supply the muscles moving it and the skin overlying those muscles — the obturator nerve's territory spans hip to knee.", "When the hip joint is diseased (arthritis, AVN, SUFE), visceral-type referred pain travels along the obturator nerve and is perceived at the <b>medial distal thigh and knee</b>.", ], "Children with hip pathology (e.g., <b>Perthes disease, SUFE</b>) frequently present with " "isolated knee pain — always examine the hip in any child with unexplained knee pain."), (18, "Caput medusae is seen at the umbilicus.", "In <b>portal hypertension</b>, collateral veins open at the umbilicus via <b>paraumbilical veins</b> " "(fetal umbilical vein remnants) connecting the portal system to superficial epigastric veins " "through the falciform ligament — the distended veins radiate from the umbilicus.", [ "<b>Paraumbilical veins</b> run within the falciform ligament, connecting the left branch of the portal vein to the superficial epigastric veins at the umbilicus.", "In portal hypertension (portal pressure >10 mmHg), blood flows <b>retrograde</b> through these veins into the systemic epigastric veins.", "This <b>portosystemic anastomosis</b> at the umbilicus visibly distends the periumbilical subcutaneous veins, producing the caput medusae (snake-head) appearance.", ], "Caput medusae is one of four classic portosystemic anastomotic sites; the others are " "<b>lower oesophagus</b> (oesophageal varices), <b>rectum</b> (rectal varices), and " "<b>bare area of liver</b> — all become clinically significant in cirrhosis."), (19, "Femoral hernia is more common in females than males.", "Same mechanism as Q14 — <b>wider gynecoid pelvis → wider femoral ring → easier herniation</b>.", [ "<b>Gynecoid pelvis</b>: wider inter-ischial diameter and wider angle between inguinal and pectineal ligaments → larger femoral ring.", "The femoral canal is a potential space with only loose areolar tissue and Cloquet's node — minimal resistance to herniation.", "Females also have higher baseline <b>intra-abdominal pressure</b> variation (pregnancy, parturition) contributing to progressive femoral ring dilatation.", ], "Femoral hernia has the <b>highest strangulation rate (~40%)</b> of all groin hernias due to " "the rigid, unyielding femoral ring; urgent surgical repair is indicated even for asymptomatic cases.", note="Repeat of Q14. Same answer applies."), (20, "Thorax is circular in children but kidney-shaped (elliptical) in adults.", "In infants, <b>ribs are nearly horizontal</b> (AP diameter ≈ transverse diameter → circular). " "With upright posture and growth, ribs become <b>oblique</b> and the transverse diameter exceeds " "the AP diameter, producing the adult kidney-shaped (elliptical) cross-section.", [ "In infants, predominantly <b>supine posture</b> and horizontal ribs mean AP ≈ transverse diameter — circular cross-section on transverse imaging.", "With upright posture, costal angle increases, <b>transverse diameter expands disproportionately</b>, and the AP dimension flattens relative to the transverse.", "By adulthood, transverse &gt; AP diameter gives the characteristic <b>reniform (kidney-shaped) cross-section</b> on CT/transverse section.", ], "<b>Barrel chest</b> (adult thorax reverting to circular: AP ≈ transverse) is a classic sign of " "COPD due to lung hyperinflation restoring horizontal rib orientation."), (21, "Referred pain of gallbladder is felt at the tip of the right shoulder.", "Gallbladder pain is referred to the <b>right shoulder tip</b> because the inflamed gallbladder " "irritates the overlying <b>diaphragm</b>, which is innervated by the <b>phrenic nerve (C3–C5)</b> — " "the same cervical segments that supply the shoulder tip skin via supraclavicular nerves (C3–C4).", [ "The <b>diaphragm</b> (C3–C5, phrenic nerve) lies directly above the gallbladder fossa; inflammation spreads to the diaphragmatic peritoneum.", "<b>Convergence of phrenic (C3–C4) and supraclavicular (C3–C4) inputs</b> at the same dorsal horn level causes diaphragmatic pain to be perceived at the right shoulder tip.", "This is the anatomical basis of <b>Kehr's sign</b> (left shoulder tip pain in splenic rupture) and right shoulder tip pain in biliary/hepatic pathology.", ], "Right shoulder tip pain without shoulder pathology should prompt evaluation of " "<b>biliary, hepatic, or right subphrenic disease</b>; it also occurs with right hemothorax or pleural effusion."), (22, "Varicocele is more common on left side.", "Same mechanism as Q6 and Q16 — <b>left testicular vein's 90° angle into left renal vein</b> " "creates higher hydrostatic back-pressure and valve incompetence.", [ "<b>Left testicular vein → left renal vein</b> at 90°: hydrostatic column effect, valve failure, venous dilatation.", "<b>Right testicular vein → IVC</b> at an oblique angle: short, low-resistance, competent valves.", "<b>Sigmoid colon</b> compression of the left spermatic vein adds further venous obstruction.", ], "Varicocele is a <b>correctable cause of male infertility</b>; left-sided predominance means " "left varicocelectomy is the most commonly performed procedure.", note="Repeat of Q6 and Q16. Same answer."), (23, "Perineal body tear may lead to prolapse of pelvic organs.", "The <b>perineal body</b> is the central tendinous keystone of the pelvic floor where multiple " "pelvic floor muscles converge. Its tear disrupts the entire structural support system, " "allowing pelvic organs to descend through the weakened floor.", [ "Muscles converging on the perineal body: <b>bulbospongiosus, superficial and deep transverse perinei, external anal sphincter, pubococcygeus (levator ani), urogenital diaphragm</b> — a true 'keystone.'", "Tearing (especially <b>obstetric 3rd/4th degree lacerations</b>) disrupts this convergent support, allowing the anterior rectal wall (rectocele) and posterior vaginal wall to herniate.", "Loss of perineal body integrity weakens the <b>rectovaginal septum</b>, directly predisposing to <b>rectocele and uterovaginal prolapse</b>.", ], "Early surgical repair (<b>perineorrhaphy</b>) of significant perineal tears post-delivery is " "essential to prevent long-term pelvic organ prolapse, urinary incontinence, and faecal incontinence."), (24, "Anatomical basis for spread of breast carcinoma.", "Breast carcinoma spreads via <b>lymphatics, blood vessels, and direct extension</b>, with the " "<b>axillary lymph nodes</b> (receiving 75% of breast lymphatic drainage) being the most common " "first site of nodal metastasis.", [ "<b>Lymphatic routes</b>: Axillary nodes (75% — lateral/central quadrants via axillary tail); Internal mammary nodes (medial quadrants); Supraclavicular nodes (advanced disease).", "<b>Blood-borne spread</b>: Via axillary/intercostal veins → lung, vertebrae (via Batson's plexus), liver, brain — the most common distant metastatic sites.", "<b>Direct extension</b>: Skin dimpling (peau d'orange) via Cooper's ligament tethering; nipple retraction via lactiferous duct involvement; chest wall invasion via pectoralis fascia.", ], "<b>Sentinel lymph node biopsy</b> targets the first axillary node in the lymphatic chain; " "its status accurately predicts axillary nodal burden and avoids unnecessary full axillary clearance."), (25, "Varicocele is common on the left side.", "Same mechanism as Q6, Q16, Q22 — left testicular vein anatomy predisposes to venous stasis.", [ "<b>Left testicular vein → left renal vein</b> at 90° → higher resistance and pressure → valve incompetence.", "<b>Right testicular vein → IVC</b> obliquely → lower pressure, competent valves.", "Additional compression by <b>sigmoid colon</b> on left spermatic vein.", ], "Clinical importance: varicocele is a <b>treatable cause of oligospermia</b> and male infertility; " "sudden right-sided varicocele mandates urgent renal/retroperitoneal imaging.", note="Repeat of Q6/Q16/Q22."), (26, "Pain over the tip of right shoulder in cholecystitis.", "In acute cholecystitis, the inflamed gallbladder irritates the <b>diaphragmatic peritoneum</b>, " "which is innervated by the <b>phrenic nerve (C3–C5)</b> — same cervical segments (C3–C4) as " "the supraclavicular nerves supplying the right shoulder tip skin.", [ "The gallbladder fossa lies immediately beneath the <b>right dome of the diaphragm</b>; pericholecystic inflammation spreads to the diaphragmatic peritoneum.", "<b>Convergence of phrenic (C3–C4) and supraclavicular nerve (C3–C4) signals</b> at the same dorsal horn level → visceral diaphragmatic pain perceived at the right shoulder tip.", "<b>Murphy's sign</b> (arrest of inspiration on right subcostal palpation) and right shoulder tip pain together are highly specific for acute cholecystitis.", ], "Right shoulder tip pain + Murphy's sign + fever + RUQ tenderness = <b>classic acute cholecystitis</b>; " "same mechanism as gallbladder referred pain (Q21).", note="Same mechanism as Q21."), (27, "Hip joint is more stable than the shoulder joint.", "The hip joint is inherently more stable due to its <b>deep bony socket (acetabulum)</b>, " "complete labrum, the body's strongest ligaments, and bulky musculature — all " "sacrificing mobility for stability and weight-bearing.", [ "<b>Bony stability</b>: The acetabulum covers >50% of the femoral head; the glenoid covers only 25–30% of the humeral head ('golf ball on a tee').", "<b>Ligamentous stability</b>: The <b>iliofemoral ligament (Y-ligament of Bigelow)</b> is the strongest ligament in the body, preventing hyperextension; the shoulder relies primarily on the rotator cuff for dynamic stability.", "<b>Labrum</b>: The acetabular labrum deepens the socket and creates a suction-seal effect; the glenoid labrum provides far less bony containment.", ], "Because the hip sacrifices mobility for stability, <b>hip dislocations</b> require far greater " "force (high-energy trauma) than shoulder dislocations; posterior dislocation is most common."), (28, "Twinning in pregnancy.", "Twins arise either from <b>two separate fertilised ova (dizygotic/fraternal)</b> or from " "<b>division of a single fertilised ovum (monozygotic/identical)</b>, with chorionicity and " "amnionicity determined by the timing of division in monozygotic twins.", [ "<b>Dizygotic (DZ, 70%)</b>: Two ova + two sperm → always dichorionic, diamniotic (DCDA). Genetically distinct. Higher incidence with ovulation induction/ART.", "<b>Monozygotic (MZ, 30%)</b> — timing determines type: Days 1–3: DCDA (safest); Days 4–8: Monochorionic diamniotic (MCDA — risk of TTTS); Days 8–12: Monochorionic monoamniotic (MCMA — cord entanglement); Days 13+: Conjoined twins.", "<b>Monochorionic twins</b> share placental circulation → risk of <b>Twin-to-Twin Transfusion Syndrome (TTTS)</b> in MCDA twins via arteriovenous anastomoses.", ], "Chorionicity must be established by <b>early ultrasound (11–14 weeks)</b> via the lambda sign " "(DCDA) or T-sign (MCDA) — it determines antenatal surveillance intensity and pregnancy risk."), (29, "Great saphenous vein is commonly involved in varicosity.", "The <b>great saphenous vein (GSV)</b> is most commonly affected by varicosities because it is " "the longest vein in the body, subject to the greatest hydrostatic pressure in the upright position, " "and because <b>saphenofemoral junction (SFJ) incompetence</b> allows deep venous reflux into the saphenous system.", [ "The <b>SFJ</b> (GSV joins the femoral vein, 4 cm below and lateral to the pubic tubercle) has a terminal valve — when incompetent, it allows retrograde femoral venous blood into the GSV.", "The GSV runs <b>superficially</b> in the subcutaneous tissue with minimal fascial support, unable to withstand high luminal pressure without dilating and elongating (varicosity).", "In the erect position, the venous column from the SFJ to the ankle creates a hydrostatic pressure of <b>~80–100 mmHg</b> — the highest sustained venous pressure in the body.", ], "The <b>Trendelenburg test</b> identifies SFJ incompetence; modern treatment options include " "endovenous laser ablation (EVLA), radiofrequency ablation, or foam sclerotherapy."), ] # ══════════════════════════════════════════════════════════════════════════════ # BUILD STORY # ══════════════════════════════════════════════════════════════════════════════ # Section header story.append(Paragraph("29 High-Yield Anatomy Q&amp;A", ParagraphStyle("sh", fontSize=16, leading=20, textColor=DARK_BLUE, fontName="Helvetica-Bold", alignment=TA_CENTER, spaceAfter=4))) story.append(Paragraph( "1st Year MBBS · RUHS · 3-Mark Why &amp; Short Essay Answers", ParagraphStyle("sh2", fontSize=11, leading=14, textColor=MID_GRAY, fontName="Helvetica", alignment=TA_CENTER, spaceAfter=6))) story.append(HRFlowable(width="100%", thickness=2, color=ROYAL_BLUE, spaceAfter=10)) for item in qa_data: if len(item) == 5: num, q, core, bullets, takeaway = item story.append(qa_block(num, q, core, bullets, takeaway)) else: num, q, core, bullets, takeaway, note = item story.append(qa_block(num, q, core, bullets, takeaway, note=note)) # ── Footer on every page ─────────────────────────────────────────────────────── def add_page_number(canvas, doc): canvas.saveState() # Header bar canvas.setFillColor(DARK_BLUE) canvas.rect(0, H - 1.0*cm, W, 1.0*cm, fill=1, stroke=0) canvas.setFillColor(colors.white) canvas.setFont("Helvetica-Bold", 9) canvas.drawString(2*cm, H - 0.7*cm, "RUHS MBBS | 29 High-Yield Anatomy Answers") canvas.setFont("Helvetica", 9) canvas.drawRightString(W - 2*cm, H - 0.7*cm, "1st Year MBBS | Anatomy") # Gold line under header canvas.setStrokeColor(GOLD) canvas.setLineWidth(1.5) canvas.line(0, H - 1.0*cm, W, H - 1.0*cm) # Footer canvas.setFillColor(DARK_BLUE) canvas.rect(0, 0, W, 0.8*cm, fill=1, stroke=0) canvas.setFillColor(colors.white) canvas.setFont("Helvetica", 8) canvas.drawString(2*cm, 0.25*cm, "Study Smart, Score High | t.me/ruhs_mbbs") canvas.drawCentredString(W/2, 0.25*cm, f"Page {doc.page}") canvas.drawRightString(W - 2*cm, 0.25*cm, "@ruhs_mbbs") canvas.restoreState() def first_page(canvas, doc): cover_page(canvas, doc) def later_pages(canvas, doc): add_page_number(canvas, doc) doc.build(story, onFirstPage=first_page, onLaterPages=later_pages) print("PDF created successfully:", OUTPUT) PYEOF

~/ruhs-anatomy-pdf/build_pdf.py

cd /tmp/workspace/ruhs-anatomy-pdf && python3 build_pdf.py

ls -lh /tmp/workspace/ruhs-anatomy-pdf/ && python3 -c " from pypdf import PdfReader r = PdfReader('/tmp/workspace/ruhs-anatomy-pdf/RUHS_Anatomy_29_High_Yield_QA.pdf') print('Pages:', len(r.pages)) print('Title:', r.metadata.title) "