mkdir -p /home/daytona/workspace/neetpg-revision && echo "Directory ready"

~/neetpg-revision/generate_pdf.py

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, Table,
                                 TableStyle, PageBreak, HRFlowable)
from reportlab.lib.enums import TA_CENTER, TA_LEFT

OUTPUT = "/home/daytona/workspace/neetpg-revision/NEET_PG_Last_Minute_Revision.pdf"

doc = SimpleDocTemplate(
    OUTPUT,
    pagesize=A4,
    rightMargin=1.8*cm, leftMargin=1.8*cm,
    topMargin=2*cm, bottomMargin=2*cm
)

styles = getSampleStyleSheet()

# Custom styles
title_style = ParagraphStyle('MainTitle', fontSize=22, fontName='Helvetica-Bold',
    alignment=TA_CENTER, textColor=colors.HexColor('#1a237e'), spaceAfter=6)
subtitle_style = ParagraphStyle('Subtitle', fontSize=11, fontName='Helvetica',
    alignment=TA_CENTER, textColor=colors.HexColor('#37474f'), spaceAfter=20)
subj_style = ParagraphStyle('Subject', fontSize=16, fontName='Helvetica-Bold',
    textColor=colors.white, alignment=TA_CENTER, spaceAfter=4, spaceBefore=4)
h2_style = ParagraphStyle('H2', fontSize=11, fontName='Helvetica-Bold',
    textColor=colors.HexColor('#1a237e'), spaceBefore=8, spaceAfter=3)
bullet_style = ParagraphStyle('Bullet', fontSize=9, fontName='Helvetica',
    leftIndent=12, spaceAfter=2, leading=13,
    textColor=colors.HexColor('#212121'))
mnemonic_style = ParagraphStyle('Mnemonic', fontSize=9, fontName='Helvetica-BoldOblique',
    leftIndent=12, textColor=colors.HexColor('#b71c1c'), spaceAfter=2, leading=13)
note_style = ParagraphStyle('Note', fontSize=8.5, fontName='Helvetica-Oblique',
    leftIndent=12, textColor=colors.HexColor('#4a148c'), spaceAfter=2, leading=12)

def b(text): return f'<b>{text}</b>'
def red(text): return f'<font color="#c62828">{text}</font>'
def blue(text): return f'<font color="#1565c0">{text}</font>'

def subject_header(name, color_hex):
    tbl = Table([[Paragraph(name, subj_style)]], colWidths=[17.4*cm])
    tbl.setStyle(TableStyle([
        ('BACKGROUND', (0,0), (-1,-1), colors.HexColor(color_hex)),
        ('ROUNDEDCORNERS', [6,6,6,6]),
        ('TOPPADDING', (0,0), (-1,-1), 7),
        ('BOTTOMPADDING', (0,0), (-1,-1), 7),
    ]))
    return tbl

def h2(text): return Paragraph(text, h2_style)
def bp(text): return Paragraph(f'• {text}', bullet_style)
def mn(text): return Paragraph(f'★ Mnemonic: {text}', mnemonic_style)
def nt(text): return Paragraph(f'▶ {text}', note_style)
def sp(h=4): return Spacer(1, h)
def hr(): return HRFlowable(width="100%", thickness=0.5, color=colors.HexColor('#bdbdbd'), spaceAfter=4)

def two_col_table(rows, col1_title='Topic', col2_title='Key Point'):
    header = [Paragraph(b(col1_title), bullet_style), Paragraph(b(col2_title), bullet_style)]
    data = [header] + [[Paragraph(r[0], bullet_style), Paragraph(r[1], bullet_style)] for r in rows]
    tbl = Table(data, colWidths=[5.5*cm, 11.5*cm])
    tbl.setStyle(TableStyle([
        ('BACKGROUND', (0,0), (-1,0), colors.HexColor('#e3f2fd')),
        ('GRID', (0,0), (-1,-1), 0.4, colors.HexColor('#90caf9')),
        ('FONTNAME', (0,0), (-1,0), 'Helvetica-Bold'),
        ('FONTSIZE', (0,0), (-1,-1), 8.5),
        ('TOPPADDING', (0,0), (-1,-1), 3),
        ('BOTTOMPADDING', (0,0), (-1,-1), 3),
        ('VALIGN', (0,0), (-1,-1), 'TOP'),
    ]))
    return tbl

story = []

# ── COVER PAGE ──────────────────────────────────────────────────────────────
story.append(Spacer(1, 2*cm))
story.append(Paragraph("NEET PG 2026", title_style))
story.append(Paragraph("Last-Minute High-Yield Revision Notes", subtitle_style))
story.append(Paragraph("All 19 Subjects · Key Points · Mnemonics · One-Liners", subtitle_style))
story.append(Spacer(1, 0.5*cm))
cover_tbl = Table([["19 Subjects Covered"], ["Bullet Points + Mnemonics + Tables"],
                   ["Focus on Repeat & High-Yield Topics"]],
    colWidths=[14*cm])
cover_tbl.setStyle(TableStyle([
    ('BACKGROUND', (0,0), (-1,-1), colors.HexColor('#e8eaf6')),
    ('ALIGN', (0,0), (-1,-1), 'CENTER'),
    ('FONTNAME', (0,0), (-1,-1), 'Helvetica-Bold'),
    ('FONTSIZE', (0,0), (-1,-1), 11),
    ('TOPPADDING', (0,0), (-1,-1), 7),
    ('BOTTOMPADDING', (0,0), (-1,-1), 7),
    ('GRID', (0,0), (-1,-1), 0.5, colors.HexColor('#7986cb')),
]))
story.append(cover_tbl)
story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════
# 1. ANATOMY
# ═══════════════════════════════════════════════════════════════════════════
story.append(subject_header("1. ANATOMY", "#1a237e"))
story.append(sp())

story.append(h2("Cranial Nerves"))
story.append(two_col_table([
    ["CN I (Olfactory)", "Only CN without thalamic relay; passes through cribriform plate"],
    ["CN II (Optic)", "Not a true nerve – extension of brain; surrounded by meninges"],
    ["CN III (Oculomotor)", "All EOM except SO & LR; pupil constriction (parasympathetic)"],
    ["CN IV (Trochlear)", "Only CN to exit DORSALLY; supplies Superior Oblique"],
    ["CN V (Trigeminal)", "Largest CN; sensory face + motor mastication"],
    ["CN VI (Abducens)", "Supplies Lateral Rectus; long intracranial course → vulnerable"],
    ["CN VII (Facial)", "FACIAL expression, taste ant 2/3 tongue, stapedius, lacrimal/salivary"],
    ["CN VIII (Vestibulocochlear)", "Hearing + balance; cochlear (hearing), vestibular (balance)"],
    ["CN IX (Glossopharyngeal)", "Taste post 1/3 tongue, stylopharyngeus, parotid (parasympathetic)"],
    ["CN X (Vagus)", "Widest distribution; heart, lungs, GI tract up to splenic flexure"],
    ["CN XI (Accessory)", "SCM + Trapezius"],
    ["CN XII (Hypoglossal)", "All intrinsic & extrinsic tongue muscles EXCEPT palatoglossus"],
]))
story.append(mn("Oh Oh Oh To Touch And Feel Very Good Velvet, Ah Heaven"))
story.append(sp())

story.append(h2("High-Yield One-Liners"))
story.append(bp("Safest position for shoulder dislocation — Inferior (axillary nerve at risk)"))
story.append(bp("McBurney's point — 1/3 from ASIS to umbilicus (appendix base)"))
story.append(bp("Femoral triangle — NAVEL: Nerve, Artery, Vein, Empty space, Lymphatics (lateral to medial)"))
story.append(bp("Thoracic duct — drains ALL body EXCEPT right upper quadrant"))
story.append(bp("Most common site of ectopic ureter opening in female — vestibule (causes continuous dribbling)"))
story.append(bp("Ligament of Treitz — suspensory muscle of duodenum, marks DJ junction"))
story.append(bp("Circle of Willis — connects anterior + posterior cerebral circulation"))
story.append(bp("Porta hepatis contains — Portal vein (posterior), Hepatic artery (left), CBD (right)"))
story.append(bp("Processus vaginalis — patent in indirect inguinal hernia"))
story.append(bp("Recurrent laryngeal nerve — loops around right subclavian / arch of aorta (left)"))
story.append(mn("For femoral triangle: NAVY – Nerve, Artery, Vein, Y-fronts (lymphatics)"))
story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════
# 2. PHYSIOLOGY
# ═══════════════════════════════════════════════════════════════════════════
story.append(subject_header("2. PHYSIOLOGY", "#1b5e20"))
story.append(sp())

story.append(h2("Action Potential & Nerve"))
story.append(bp("Resting membrane potential: -70 mV (neuron), -90 mV (cardiac muscle)"))
story.append(bp("Threshold potential: -55 mV; Overshoot: +30 mV"))
story.append(bp("Refractory period — Absolute: Na⁺ channels inactivated; Relative: K⁺ still open"))
story.append(bp("Fastest nerve fibers: A-alpha (proprioception, motor); Slowest: C fibers (pain, unmyelinated)"))
story.append(mn("Sally Sells Speed And Cool Products – Aα, Aβ, Aγ, Aδ, B, C"))
story.append(sp())

story.append(h2("Cardiac Physiology"))
story.append(two_col_table([
    ["SA node pacemaker rate", "60-100/min (dominant pacemaker)"],
    ["AV node rate", "40-60/min"],
    ["His-Purkinje", "20-40/min"],
    ["Starling's law", "↑ preload → ↑ stroke volume (up to a limit)"],
    ["Cardiac output", "HR × SV; normal ~5 L/min"],
    ["PR interval", "0.12-0.20 s (AV conduction time)"],
    ["QRS duration", "<0.12 s (ventricular depolarization)"],
    ["QTc", "<0.44 s men, <0.46 s women"],
]))
story.append(sp())

story.append(h2("Renal Physiology"))
story.append(bp("GFR: ~125 mL/min; measured by inulin (gold standard) or creatinine clearance"))
story.append(bp("Glucose threshold for reabsorption: ~180 mg/dL (Tm = 320 mg/dL)"))
story.append(bp("ADH (vasopressin) — acts on collecting duct; increases water reabsorption"))
story.append(bp("Aldosterone — acts on DCT/collecting duct; Na⁺ reabsorption, K⁺ excretion"))
story.append(bp("Loop of Henle — countercurrent multiplier; thick ascending limb impermeable to water"))
story.append(sp())

story.append(h2("Respiratory"))
story.append(bp("Tidal volume: 500 mL; Dead space: 150 mL; Alveolar ventilation: 350 mL"))
story.append(bp("FRC = ERV + RV (cannot be measured by spirometry alone)"))
story.append(bp("Oxygen-Hb dissociation curve shifts RIGHT with: ↑ CO₂, ↑ temp, ↑ 2,3-DPG, ↓ pH"))
story.append(bp("Hering-Breuer reflex — lung stretch → inhibits inspiration"))
story.append(mn("CADET face right: CO₂, Altitude/Activity, DPG, Exercise, Temp → Right shift"))
story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════
# 3. BIOCHEMISTRY
# ═══════════════════════════════════════════════════════════════════════════
story.append(subject_header("3. BIOCHEMISTRY", "#b71c1c"))
story.append(sp())

story.append(h2("Enzyme Deficiencies - High Yield"))
story.append(two_col_table([
    ["PKU", "Phenylalanine hydroxylase deficiency; musty odor, fair skin, intellectual disability"],
    ["Alkaptonuria", "Homogentisate oxidase deficiency; dark urine, ochronosis, arthritis"],
    ["Maple Syrup Urine Disease", "Branched-chain α-keto acid dehydrogenase; sweet urine, neurological"],
    ["Homocystinuria", "Cystathionine β-synthase; lens dislocation (DOWN), Marfan-like, DVT"],
    ["Gaucher disease", "Glucocerebrosidase; most common lysosomal storage disease; Erlenmeyer flask"],
    ["Niemann-Pick", "Sphingomyelinase; cherry-red spot, foam cells"],
    ["Tay-Sachs", "Hexosaminidase A; cherry-red spot, NO organomegaly"],
    ["Fabry", "α-galactosidase A; X-linked; angiokeratomas, renal failure"],
    ["Hurler syndrome", "α-L-iduronidase; coarse facies, corneal clouding, mental retardation"],
    ["Hunter syndrome", "Iduronate-2-sulfatase; X-linked; NO corneal clouding"],
    ["Pompe disease", "α-1,4-glucosidase (acid maltase); cardiomegaly, hypotonia"],
    ["Von Gierke", "Glucose-6-phosphatase; fasting hypoglycemia, hepatomegaly, ↑ uric acid"],
]))
story.append(sp())

story.append(h2("Vitamins Quick Reference"))
story.append(two_col_table([
    ["Vit A", "Night blindness, xerophthalmia; retinoic acid → gene expression"],
    ["Vit B1 (Thiamine)", "Wernicke-Korsakoff, Beriberi; TPP cofactor; ↑ pyruvate in deficiency"],
    ["Vit B2 (Riboflavin)", "FAD/FMN; angular cheilitis, corneal neovascularization"],
    ["Vit B3 (Niacin)", "Pellagra (3D: Dermatitis, Diarrhea, Dementia); NAD/NADP"],
    ["Vit B6 (Pyridoxine)", "Transamination cofactor; INH causes deficiency → peripheral neuropathy"],
    ["Vit B12", "Pernicious anemia, subacute combined degeneration; intrinsic factor needed"],
    ["Vit C", "Scurvy; collagen synthesis (hydroxylation of proline/lysine); ↑ iron absorption"],
    ["Vit D", "1,25-(OH)₂ D3 active form; ↑ Ca & PO₄ absorption; deficiency → rickets/osteomalacia"],
    ["Vit E", "Antioxidant; hemolytic anemia in newborns; spinocerebellar degeneration"],
    ["Vit K", "Factors II, VII, IX, X, Protein C & S; warfarin antagonizes"],
]))
story.append(mn("Fat-soluble vitamins: ADEK – stored in fat, can be toxic in excess"))
story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════
# 4. PATHOLOGY
# ═══════════════════════════════════════════════════════════════════════════
story.append(subject_header("4. PATHOLOGY", "#4a148c"))
story.append(sp())

story.append(h2("Inflammation"))
story.append(bp("Acute inflammation mediators: Histamine (early), PGs, Leukotrienes, Cytokines (IL-1, TNF, IL-6)"))
story.append(bp("Chronic granulomatous disease — NADPH oxidase defect; catalase +ve organisms (S. aureus, Aspergillus)"))
story.append(bp("Types of necrosis:"))
story.append(bp("  - Coagulative: ischemia (except brain) — architecture preserved"))
story.append(bp("  - Liquefactive: brain infarct, abscess — architecture lost"))
story.append(bp("  - Caseous: TB — cheese-like, granuloma center"))
story.append(bp("  - Fat necrosis: pancreatitis, trauma — saponification, Ca²⁺ deposits"))
story.append(bp("  - Fibrinoid: immune complex vasculitis, malignant HTN"))
story.append(bp("  - Gangrenous: limb ischemia (dry) or with infection (wet/gas)"))
story.append(sp())

story.append(h2("Oncology High-Yield"))
story.append(two_col_table([
    ["p53 mutation", "Most common in ALL human cancers; Li-Fraumeni syndrome"],
    ["BCR-ABL", "CML; t(9;22) Philadelphia chromosome; imatinib target"],
    ["t(14;18)", "Follicular lymphoma; BCL-2 overexpression (anti-apoptosis)"],
    ["t(8;14)", "Burkitt lymphoma; c-MYC activation; starry sky pattern"],
    ["t(15;17)", "APL (AML-M3); PML-RARα; treated with ATRA"],
    ["Reed-Sternberg cells", "Hodgkin lymphoma; CD15+, CD30+; 'owl-eye' nucleus"],
    ["BRCA1/BRCA2", "Breast + ovarian cancer; DNA repair (homologous recombination)"],
    ["RB gene", "Retinoblastoma; osteosarcoma; 'two-hit hypothesis'"],
    ["APC gene", "FAP; colorectal cancer; chromosome 5q"],
    ["HER2/neu (ERBB2)", "Breast cancer; trastuzumab target; worse prognosis if overexpressed"],
]))
story.append(sp())

story.append(h2("Amyloidosis"))
story.append(bp("AL amyloid — plasma cell dyscrasia (myeloma); λ > κ light chains"))
story.append(bp("AA amyloid — chronic inflammation (RA, TB, osteomyelitis); SAA protein"))
story.append(bp("Aβ2M — dialysis-related; β2-microglobulin; carpal tunnel"))
story.append(bp("Transthyretin (TTR) — familial + senile cardiac amyloid"))
story.append(bp("Congo red stain → apple-green birefringence under polarized light"))
story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════
# 5. PHARMACOLOGY
# ═══════════════════════════════════════════════════════════════════════════
story.append(subject_header("5. PHARMACOLOGY", "#e65100"))
story.append(sp())

story.append(h2("Autonomic Pharmacology"))
story.append(two_col_table([
    ["Atropine", "Muscarinic antagonist; tachycardia, mydriasis, dry mouth, urinary retention"],
    ["Physostigmine", "Reversible AChE inhibitor; crosses BBB; antidote for anticholinergic toxicity"],
    ["Neostigmine", "Reversible AChE inhibitor; does NOT cross BBB; reverses NMJ blockade"],
    ["Prazosin", "α1 blocker; BPH + HTN; first-dose syncope"],
    ["Propranolol", "Non-selective β blocker; contraindicated in asthma; ↓ renin"],
    ["Metoprolol", "β1 selective; safe in asthma (relatively); heart failure"],
    ["Clonidine", "α2 agonist (central); ↓ sympathetic outflow; HTN, opioid withdrawal"],
]))
story.append(sp())

story.append(h2("Antibiotic Quick Reference"))
story.append(two_col_table([
    ["Penicillin", "Cell wall synthesis inhibitor; cross allergy with cephalosporins (~1%)"],
    ["Methicillin/Oxacillin", "Penicillinase-resistant; MRSA resistant (altered PBP)"],
    ["Vancomycin", "Glycopeptide; MRSA drug of choice; Red man syndrome (slow infusion)"],
    ["Aminoglycosides", "30S ribosome inhibitor; nephrotoxic + ototoxic; bactericidal"],
    ["Tetracyclines", "30S inhibitor; chelates Ca²⁺; avoid in children/pregnancy; photosensitivity"],
    ["Macrolides", "50S inhibitor; drug of choice for atypicals; QT prolongation"],
    ["Fluoroquinolones", "DNA gyrase inhibitor; avoid <18 yrs (cartilage); Achilles tendon rupture"],
    ["Metronidazole", "Anaerobes + protozoa; metallic taste; disulfiram-like reaction with alcohol"],
    ["Rifampicin", "RNA polymerase inhibitor; potent CYP450 inducer; orange urine/secretions"],
    ["Chloramphenicol", "50S; aplastic anemia (idiosyncratic), gray baby syndrome"],
]))
story.append(mn("Buy AT 30, CCEL at 50 – Aminoglycosides/Tetracyclines at 30S; Chloramphenicol/Clindamycin/Erythromycin/Linezolid at 50S"))
story.append(sp())

story.append(h2("Drug-induced Conditions (High Repeat)"))
story.append(bp("SLE-like: Hydralazine, Procainamide, INH, Methyldopa, Phenytoin (HIPMP)"))
story.append(bp("Pulmonary fibrosis: Bleomycin, Busulfan, Amiodarone, Methotrexate"))
story.append(bp("Gingival hyperplasia: Phenytoin, Cyclosporine, Nifedipine (PCN)"))
story.append(bp("Hepatotoxic: INH, Rifampicin, Pyrazinamide, Halothane, Valproate, Methotrexate"))
story.append(bp("Gynecomastia: Spironolactone, Digoxin, Ketoconazole, Cimetidine, Finasteride"))
story.append(bp("Ototoxicity: Aminoglycosides, Furosemide, Quinine, Salicylates (high dose)"))
story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════
# 6. MICROBIOLOGY
# ═══════════════════════════════════════════════════════════════════════════
story.append(subject_header("6. MICROBIOLOGY", "#006064"))
story.append(sp())

story.append(h2("Gram Positive Organisms"))
story.append(two_col_table([
    ["S. aureus", "Coagulase +ve; TSST-1 (TSS); Protein A (anti-phagocytic); PVL toxin (skin)"],
    ["S. pyogenes (GAS)", "β-hemolytic; M protein; rheumatic fever, glomerulonephritis"],
    ["S. pneumoniae", "α-hemolytic; optochin sensitive; lancet-shaped diplococci; IgA protease"],
    ["S. viridans", "α-hemolytic; optochin resistant; subacute endocarditis (damaged valves)"],
    ["Listeria", "Tumbling motility; cold enrichment; neonatal meningitis, pregnant women"],
    ["C. perfringens", "Gas gangrene; double zone β-hemolysis; Nagler reaction"],
    ["C. difficile", "Pseudomembranous colitis; post-antibiotic; treat with vancomycin/fidaxomicin"],
    ["C. tetani", "Tetanospasmin; inhibits glycine/GABA (inhibitory NT) → spastic paralysis"],
    ["C. botulinum", "Flaccid paralysis; blocks ACh release at NMJ; honey (infant botulism)"],
]))
story.append(sp())

story.append(h2("Gram Negative Organisms"))
story.append(two_col_table([
    ["N. gonorrhoeae", "No capsule, no maltose fermentation; oxidase +ve; urethritis, PID"],
    ["N. meningitidis", "Ferments maltose; meningitis, Waterhouse-Friderichsen syndrome"],
    ["H. influenzae", "Requires X (hemin) + V (NAD) factors; epiglottitis; type b"],
    ["Bordetella pertussis", "Whooping cough; pertussis toxin (↑ cAMP); Bordet-Gengou medium"],
    ["H. pylori", "Urease +ve; PUD, gastric cancer, MALT lymphoma; CLO test"],
    ["Salmonella typhi", "Rose spots, relative bradycardia; Widal test; intracellular"],
    ["Shigella", "Shiga toxin; HUS in S. dysenteriae; 4Fs: Feces, Flies, Fingers, Food"],
    ["V. cholerae", "Rice-water stools; cholera toxin (↑↑ cAMP); ORS treatment"],
    ["Pseudomonas", "Blue-green pigment (pyocyanin); burns, CF, hospital infections; ecthyma gangrenosum"],
    ["Klebsiella", "Currant jelly sputum; pneumonia in alcoholics; UTI; capsule"],
]))
story.append(sp())

story.append(h2("Fungal Infections"))
story.append(bp("Candida — pseudohyphae; germ tube test; thrush, esophagitis (immunocompromised)"))
story.append(bp("Aspergillus — acute angle branching (45°); angioinvasive; CXR: halo sign → air crescent"))
story.append(bp("Mucor/Rhizopus — wide angle branching (90°); rhinocerebral in diabetics; necrotic black eschar"))
story.append(bp("Cryptococcus — India ink stain; latex agglutination; meningitis in HIV; soap bubble lesions"))
story.append(bp("Histoplasma — intracellular; Ohio/Mississippi valley; bird/bat droppings"))
story.append(bp("Coccidioides — spherules in tissue; San Joaquin valley (desert); erythema nodosum"))
story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════
# 7. FORENSIC MEDICINE
# ═══════════════════════════════════════════════════════════════════════════
story.append(subject_header("7. FORENSIC MEDICINE & TOXICOLOGY", "#37474f"))
story.append(sp())

story.append(h2("Postmortem Changes"))
story.append(two_col_table([
    ["Pallor mortis", "Immediately after death — pallor of skin"],
    ["Algor mortis", "Body cooling; 1°C/hour; affected by environment"],
    ["Livor mortis (rigor lividity)", "Hypostasis; starts 1-2h, fixed at 6-8h; dark red/purple"],
    ["Rigor mortis", "Starts 2-6h; complete 12h; passes off 24-48h; starts jaw → spreads"],
    ["Putrefaction", "Decomposition; starts 24-48h; green discoloration first in right iliac fossa"],
]))
story.append(sp())

story.append(h2("Important Medicolegal Points"))
story.append(bp("IPC Section 302 — Murder; Section 304A — Culpable homicide not amounting to murder"))
story.append(bp("MTP Act 1971 (amended 2021) — up to 20 weeks with 1 doctor; up to 24 weeks with 2 doctors for special categories"))
story.append(bp("POCSO Act — Protection of Children from Sexual Offences; below 18 years"))
story.append(bp("Dying declaration — admissible even without magistrate if death imminent; made to any person"))
story.append(bp("Diatoms — assist in diagnosing drowning (freshwater); persist in bone marrow"))
story.append(bp("Drowning: wet = water in lungs; dry = laryngospasm; secondary = delayed pulmonary edema"))
story.append(bp("Putrefaction first sign — greenish discolouration RIGHT iliac fossa (cecum → thin wall)"))
story.append(bp("Adipocere — saponification; moist conditions; fatty acids replace soft tissue"))
story.append(sp())

story.append(h2("Toxicology"))
story.append(two_col_table([
    ["Organophosphate poisoning", "SLUDGE: Salivation, Lacrimation, Urination, Defecation, GI upset, Emesis; ↓AChE; Rx: Atropine + Pralidoxime"],
    ["CO poisoning", "Cherry red skin; carboxyhemoglobin; 100% O₂; pulse ox unreliable"],
    ["Cyanide", "Bitter almond smell; inhibits cytochrome oxidase (complex IV); Rx: hydroxocobalamin/dicobalt edetate"],
    ["Lead poisoning", "Burton's line (gums); basophilic stippling; wristdrop/footdrop; EDTA chelation"],
    ["Mercury poisoning", "Acrodynia (pink disease) in kids; Minamata disease; erethism"],
    ["Arsenic poisoning", "Aldrich-Mees lines (nails); rain-drop pigmentation; Rx: BAL (dimercaprol)"],
    ["Methanol", "Formic acid → optic nerve damage; treat with ethanol or fomepizole"],
    ["Opioid overdose", "Pin-point pupils, resp depression; Rx: naloxone"],
    ["BZD overdose", "Resp depression; Rx: flumazenil"],
]))
story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════
# 8. COMMUNITY MEDICINE (PSM)
# ═══════════════════════════════════════════════════════════════════════════
story.append(subject_header("8. COMMUNITY MEDICINE (PSM)", "#1a237e"))
story.append(sp())

story.append(h2("Epidemiology"))
story.append(two_col_table([
    ["Sensitivity", "TP/(TP+FN) – ability to detect TRUE positives; rules OUT disease (SnNOut)"],
    ["Specificity", "TN/(TN+FP) – ability to identify TRUE negatives; rules IN disease (SpPIn)"],
    ["PPV", "TP/(TP+FP) – depends on prevalence; ↑ prevalence → ↑ PPV"],
    ["NPV", "TN/(TN+FN) – depends on prevalence; ↑ prevalence → ↓ NPV"],
    ["Attack rate", "# new cases / population at risk × 100 (epidemic context)"],
    ["Incidence", "New cases in a period; used in causation studies"],
    ["Prevalence", "All cases at a point/period; = Incidence × Duration"],
    ["Odds ratio", "Case-control studies; approximates RR when disease rare"],
    ["Relative risk", "Cohort studies; RR = incidence in exposed / incidence in unexposed"],
    ["NNT", "1/(ARR); lower = better treatment"],
]))
story.append(sp())

story.append(h2("National Programs & Vaccines"))
story.append(bp("UIP (Universal Immunization Program) — BCG, OPV, Hepatitis B, Pentavalent, IPV, PCV, Rotavirus, MMR, JE, TT"))
story.append(bp("Pulse Polio — OPV; eradicated polio from India (last case 2011)"))
story.append(bp("RCH Program — Reproductive & Child Health; targets IMR, MMR"))
story.append(bp("RNTCP → renamed to NTEP (National TB Elimination Program); DOTS; target 2025 TB elimination"))
story.append(bp("NVBDCP — National Vector Borne Disease Control Program (malaria, dengue, filaria, JE, kala-azar)"))
story.append(bp("Cold chain: vaccine storage -15 to -25°C (OPV); +2 to +8°C (most others)"))
story.append(bp("BCG — at birth; ID injection; left arm deltoid region"))
story.append(bp("Contraindications for OPV — immunocompromised → use IPV instead"))
story.append(sp())

story.append(h2("Nutrition"))
story.append(bp("Kwashiorkor — protein deficiency; edema, fatty liver, flaky paint dermatosis, moon face"))
story.append(bp("Marasmus — calorie deficiency; wasting, NO edema, monkey facies"))
story.append(bp("PEM: MUAC <12.5 cm = SAM; 12.5-13.5 cm = MAM"))
story.append(bp("Obesity: BMI ≥30 (WHO); ≥25 overweight; Waist-hip ratio: >0.85 (F), >0.90 (M) = abdominal obesity"))
story.append(bp("ICDS — Integrated Child Development Services; for <6 years + pregnant/lactating women"))
story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════
# 9. MEDICINE
# ═══════════════════════════════════════════════════════════════════════════
story.append(subject_header("9. INTERNAL MEDICINE", "#880e4f"))
story.append(sp())

story.append(h2("Cardiology"))
story.append(bp("STEMI management: Fibrinolysis if PCI not available within 120 min; preferred within 90 min of first contact"))
story.append(bp("Heart failure: EF <40% = HFrEF; treat with ACEi/ARB, β-blocker, spironolactone, SGLT2i"))
story.append(bp("Atrial fibrillation: rate control (β-blocker/digoxin) vs rhythm control; anticoagulate if CHA₂DS₂-VASc ≥2"))
story.append(bp("Hypertension: ≥130/80 (ACC/AHA); ≥140/90 (JNC 7); 1st line: ACEi, ARB, CCB, thiazide"))
story.append(bp("MVP — most common valvular disease; mid-systolic click; Rx if symptomatic"))
story.append(bp("AS: slow-rising pulse, heaving apex, ejection systolic murmur; LVSOGP"))
story.append(sp())

story.append(h2("Respiratory Medicine"))
story.append(two_col_table([
    ["COPD", "FEV1/FVC <0.70 post-bronchodilator; GOLD staging by FEV1%; emphysema (centriacinar = smoking; panacinar = α1AT)"],
    ["Asthma", "Reversible obstruction; ↑ FEV1 ≥12% after bronchodilator; Charcot-Leyden crystals"],
    ["Pneumonia", "CAP: Strep pneumoniae #1; atypical: Mycoplasma; HAP: Pseudomonas/Klebsiella"],
    ["TB", "Ziehl-Neelsen (ZN) stain; Lowenstein-Jensen medium; HRZE 2 months + HR 4 months"],
    ["Pleural effusion", "Light's criteria: exudate if protein >3g/dL or fluid/serum ratio >0.5"],
    ["Lung cancer", "Adenocarcinoma: most common overall; SCC: central, cavitates, PTHrP; SCLC: ACTH/ADH"],
    ["Sarcoidosis", "Non-caseating granulomas; bilateral hilar lymphadenopathy; ↑ ACE; treat with steroids"],
    ["IPF", "Honeycombing on HRCT; UIP pattern; poor prognosis; nintedanib/pirfenidone"],
]))
story.append(sp())

story.append(h2("Gastroenterology"))
story.append(bp("Liver cirrhosis: portal HTN → varices, splenomegaly, ascites; Child-Pugh/MELD scoring"))
story.append(bp("Hepatitis B markers: HBsAg (active infection), Anti-HBs (immunity), HBeAg (high infectivity)"))
story.append(bp("IBD: Crohn's = transmural, skip lesions, cobblestone, string sign, fistulae; UC = mucosal, continuous, pseudopolyps"))
story.append(bp("Peptic ulcer: DU (duodenal) — nocturnal pain, relieved by food; GU (gastric) — pain worsened by food"))
story.append(bp("Pancreatitis: Ranson's criteria at admission and 48h; CT severity index; treat with fluids + analgesia"))
story.append(bp("Achalasia: bird-beak esophagus on barium; manometry = LES hypertension + failed relaxation"))
story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════
# 10. SURGERY
# ═══════════════════════════════════════════════════════════════════════════
story.append(subject_header("10. SURGERY", "#bf360c"))
story.append(sp())

story.append(h2("Hernias"))
story.append(two_col_table([
    ["Indirect inguinal", "Most common; through deep inguinal ring; congenital; lateral to inferior epigastric"],
    ["Direct inguinal", "Through Hesselbach's triangle; acquired (elderly men); medial to inf epigastric"],
    ["Femoral hernia", "Below inguinal ligament; most common in women; highest risk of strangulation"],
    ["Richter's hernia", "Only part of bowel wall caught; no obstruction but can strangulate"],
    ["Maydl's hernia", "W-shaped loop; intervening loop inside may strangulate without external sign"],
    ["Spigelian hernia", "Through spigelian fascia; lateral to rectus abdominis; interparietal"],
    ["Obturator hernia", "Through obturator foramen; elderly women; Howship-Romberg sign (medial thigh pain)"],
]])
story.append(sp())

story.append(h2("Thyroid"))
story.append(bp("Graves disease — most common hyperthyroidism; TSH-R antibody; pretibial myxedema, exophthalmos"))
story.append(bp("Papillary carcinoma — most common thyroid cancer (80%); psammoma bodies; spreads to lymph nodes"))
story.append(bp("Follicular carcinoma — vascular invasion; blood-borne spread; FNA cannot diagnose"))
story.append(bp("Medullary carcinoma — parafollicular C cells; calcitonin marker; MEN2A/2B"))
story.append(bp("Anaplastic carcinoma — most aggressive; worst prognosis; elderly"))
story.append(sp())

story.append(h2("Breast"))
story.append(bp("Fibroadenoma — most common benign; firm, mobile, non-tender; 'breast mouse'"))
story.append(bp("Breast cancer: most common = Invasive ductal carcinoma (IDC); BRCA1/2 risk"))
story.append(bp("Sentinel lymph node biopsy — first node draining tumor bed; spares full axillary dissection"))
story.append(bp("Paget's disease of nipple — always associated with underlying ductal carcinoma"))
story.append(bp("Inflammatory breast cancer — peau d'orange, no lump, worst prognosis; dermal lymphatic invasion"))
story.append(sp())

story.append(h2("Burns"))
story.append(bp("Rule of 9s: head 9%, arm 9% each, leg 18% each, trunk 36%, perineum 1%"))
story.append(bp("Parkland formula: 4 × weight(kg) × TBSA(%) of Ringer's lactate; half in first 8h, rest in next 16h"))
story.append(bp("Full-thickness burn — painless (nerve destruction); waxy/leathery; needs skin grafting"))
story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════
# 11. OBSTETRICS & GYNAECOLOGY
# ═══════════════════════════════════════════════════════════════════════════
story.append(subject_header("11. OBSTETRICS & GYNAECOLOGY", "#4a148c"))
story.append(sp())

story.append(h2("Obstetrics"))
story.append(two_col_table([
    ["Nagele's rule", "EDD = LMP + 9 months + 7 days (or -3 months +7 days)"],
    ["PIH/Preeclampsia", "BP ≥140/90 after 20 weeks + proteinuria; severe: ≥160/110"],
    ["Eclampsia", "Preeclampsia + convulsions; MgSO₄ (Pritchard regime) first line"],
    ["Antepartum hemorrhage", "Placenta previa (painless) vs Abruptio placentae (painful, tender uterus)"],
    ["Placenta previa", "Painless, bright red bleeding; DO NOT do vaginal examination"],
    ["PPH", "Blood loss >500mL after vaginal delivery; 4 Ts: Tone, Trauma, Tissue, Thrombin"],
    ["Uterine atony", "#1 cause of PPH; Rx: oxytocin, misoprostol, ergometrine, carboprost"],
    ["Gestational DM", "Screen at 24-28 weeks; 75g OGTT; FPG ≥92 → GDM"],
    ["HELLP syndrome", "Hemolysis, Elevated LFT, Low Platelets; complication of severe preeclampsia"],
]])
story.append(sp())

story.append(h2("Gynaecology"))
story.append(bp("PCOS: Rotterdam criteria — 2 of 3: oligo/anovulation, hyperandrogenism, polycystic ovaries on USG"))
story.append(bp("Endometriosis: chocolate cysts (ovary), powder-burn lesions; CA-125 raised; infertility"))
story.append(bp("Fibroid (leiomyoma): most common benign gynecological tumor; heavy menstrual bleeding"))
story.append(bp("Cervical cancer: HPV 16 & 18; Pap smear screening; FIGO staging; treat early with surgery, advanced with chemoradiation"))
story.append(bp("Ovarian cancer: CA-125 marker; most common type = epithelial serous cystadenocarcinoma"))
story.append(bp("Endometrial cancer: most common gynecological malignancy in developed countries; postmenopausal bleeding"))
story.append(bp("Bartholin's cyst — Rx: marsupialization (not excision)"))
story.append(mn("PPH causes: 4 Ts – Tone (atony), Tissue (retained), Trauma (laceration), Thrombin (coagulopathy)"))
story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════
# 12. PAEDIATRICS
# ═══════════════════════════════════════════════════════════════════════════
story.append(subject_header("12. PAEDIATRICS", "#006064"))
story.append(sp())

story.append(h2("Growth & Development"))
story.append(two_col_table([
    ["Birth weight", "~3 kg; regained by 10-14 days; doubles by 5 months; triples by 1 year"],
    ["Birth length", "~50 cm; doubles by 4 years; 75 cm at 1 year"],
    ["Head circumference", "~35 cm at birth; equals chest circumference at ~1 year"],
    ["Fontanelles", "Posterior: closes 6-8 weeks; Anterior: closes 12-18 months"],
    ["Teething", "First tooth: 6 months; 20 milk teeth by 2 years"],
    ["Smile (social)", "6 weeks"],
    ["Neck holding", "3 months"],
    ["Sits without support", "9 months"],
    ["Walks independently", "12-15 months"],
    ["Two-word sentences", "24 months"],
]])
story.append(sp())

story.append(h2("Neonatology"))
story.append(bp("APGAR score — Appearance, Pulse, Grimace, Activity, Respiration; at 1 min & 5 min; ≥7 normal"))
story.append(bp("Surfactant (SP-A, SP-B) — produced by type II pneumocytes; lecithin/sphingomyelin >2 = lung maturity"))
story.append(bp("RDS (HMD) — surfactant deficiency in premature; ground-glass on CXR; Rx: surfactant + CPAP"))
story.append(bp("Physiological jaundice: appears >24h, peaks day 3-5, clears by day 10-14"))
story.append(bp("Pathological jaundice: <24h → hemolytic; >14 days → hypothyroidism/biliary atresia"))
story.append(bp("Rh incompatibility — Coombs +ve; hydrops fetalis; Rx: phototherapy, exchange transfusion; prevent with Anti-D immunoglobulin at 28 weeks + delivery"))
story.append(sp())

story.append(h2("Common Paediatric Diseases"))
story.append(bp("Kawasaki disease — CRASH: Conjunctivitis, Rash, Adenopathy (cervical), Strawberry tongue, Hand changes; Rx: IVIG + aspirin"))
story.append(bp("Henoch-Schönlein Purpura (IgA vasculitis) — palpable purpura legs/buttocks, arthritis, abdominal pain, hematuria; self-limiting"))
story.append(bp("Nephrotic syndrome in children: minimal change disease #1; responds to steroids"))
story.append(bp("Febrile convulsions: 6m-6yr; temperature >38.5°C; simple (<15 min, generalized); reassure parents"))
story.append(bp("Croup (laryngotracheobronchitis): parainfluenza; barking cough; steeple sign on X-ray; Rx: nebulized adrenaline, steroids"))
story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════
# 13. ORTHOPAEDICS
# ═══════════════════════════════════════════════════════════════════════════
story.append(subject_header("13. ORTHOPAEDICS", "#1b5e20"))
story.append(sp())

story.append(h2("Fractures"))
story.append(two_col_table([
    ["Colles' fracture", "Distal radius; dinner fork deformity; dorsal displacement; fall on outstretched hand"],
    ["Smith's fracture", "Reverse Colles'; volar displacement; 'reverse dinner fork'; garden spade deformity"],
    ["Scaphoid fracture", "Anatomical snuffbox tenderness; avascular necrosis risk (proximal pole); treat even if X-ray normal"],
    ["Monteggia fracture", "Ulnar fracture + radial head DISLOCATION (proximal)"],
    ["Galeazzi fracture", "Radial fracture + DRUJ dislocation (distal)"],
    ["Bennett fracture", "Intra-articular 1st metacarpal base fracture; thumb; needs ORIF"],
    ["Boxer's fracture", "5th metacarpal neck; volar displacement of head"],
    ["Lisfranc injury", "Tarsometatarsal joint disruption; often missed; instability on weight bearing"],
    ["Maisonneuve fracture", "Proximal fibula fracture + ankle instability; always X-ray full fibula with ankle injuries"],
]])
story.append(sp())

story.append(h2("High-Yield Ortho Points"))
story.append(bp("Compartment syndrome: 6 Ps — Pain, Pallor, Pulselessness, Paraesthesia, Paralysis, Poikilothermia"))
story.append(bp("Measure compartment pressure; >30 mmHg or within 30 mmHg of diastolic → fasciotomy"))
story.append(bp("Fat embolism syndrome: 24-72h post long bone fracture; petechiae (chest/axilla), confusion, hypoxia"))
story.append(bp("Osteosarcoma: most common primary malignant bone tumor (children); distal femur/proximal tibia; sunburst appearance; Codman triangle"))
story.append(bp("Ewing sarcoma: diaphysis; onion peel periosteal reaction; t(11;22); children; round cell tumor"))
story.append(bp("Osteoarthritis: crepitus, Heberden's (DIP) & Bouchard's (PIP) nodes; joint space narrowing; osteophytes"))
story.append(bp("Rheumatoid arthritis: MCP, PIP joints; spares DIP; swan neck & boutonniere deformity; anti-CCP (most specific)"))
story.append(bp("Ankylosing spondylitis: SI joints first; bamboo spine; HLA-B27; ↑ ESR; Rx: NSAIDs, anti-TNF"))
story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════
# 14. OPHTHALMOLOGY
# ═══════════════════════════════════════════════════════════════════════════
story.append(subject_header("14. OPHTHALMOLOGY", "#311b92"))
story.append(sp())

story.append(h2("Glaucoma"))
story.append(bp("POAG — most common; open angle; painless; IOP >21 mmHg; optic nerve cupping; treat with eye drops (timolol, latanoprost)"))
story.append(bp("ACAG — painful; sudden; nausea/vomiting; hazy cornea; mid-dilated fixed pupil; EMERGENCY"))
story.append(bp("NTG — normal tension glaucoma; IOP normal but optic disc cupping; vascular risk factors"))
story.append(bp("Congenital glaucoma — buphthalmos (ox eye); Haab's striae; Rx: goniotomy/trabeculotomy"))
story.append(sp())

story.append(h2("Cataract"))
story.append(bp("Most common cause of blindness worldwide (WHO) and in India"))
story.append(bp("Nuclear sclerosis: myopic shift; patients may improve reading without glasses ('second sight')"))
story.append(bp("Posterior subcapsular (PSC): associated with steroids, DM, trauma; early visual symptoms"))
story.append(bp("Diabetic cataract: snowflake cataract in young DM patients; bilateral"))
story.append(bp("Management: phacoemulsification + IOL implantation; ECCE if hard nucleus"))
story.append(sp())

story.append(h2("Retina"))
story.append(bp("Diabetic retinopathy: NPDR (microaneurysms, dot/blot hemorrhages, hard exudates) → PDR (neovascularization)"))
story.append(bp("CRVO: flame-shaped hemorrhages in all 4 quadrants; disk edema; 'blood and thunder' fundus"))
story.append(bp("CRAO: sudden painless vision loss; cherry red spot at macula; pale retina; pale optic disc"))
story.append(bp("Retinoblastoma: #1 intraocular tumor in children; leukocoria (white pupil reflex); RB gene (13q14)"))
story.append(bp("ARMD: central vision loss; drusen; wet ARMD: choroidal neovascularization → anti-VEGF (ranibizumab)"))
story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════
# 15. ENT (OTORHINOLARYNGOLOGY)
# ═══════════════════════════════════════════════════════════════════════════
story.append(subject_header("15. ENT (OTORHINOLARYNGOLOGY)", "#1a237e"))
story.append(sp())

story.append(h2("Ear"))
story.append(two_col_table([
    ["Rinne test", "BC > AC = Rinne negative = conductive hearing loss"],
    ["Weber test", "Lateralizes to affected ear in CHL; unaffected ear in SNHL"],
    ["CSOM tubotympanic", "Central perforation; mucoid discharge; safe; treat conservatively first"],
    ["CSOM atticoantral", "Marginal/attic perforation; cholesteatoma; UNSAFE; complications likely"],
    ["Otosclerosis", "Fixation of stapes footplate; low frequency CHL; Schwartze sign; Rx: stapedectomy"],
    ["Meniere's disease", "Low-frequency SNHL + episodic vertigo + tinnitus + aural fullness; low-salt diet"],
    ["Acoustic neuroma", "CN VIII schwannoma; CPA tumor; SNHL, tinnitus, unilateral; Rx: surgery/radiosurgery"],
]])
story.append(sp())

story.append(h2("Nose & Paranasal Sinuses"))
story.append(bp("Epistaxis: most common site = Little's area (Kiesselbach's plexus); anterior ethmoid artery (dangerous)"))
story.append(bp("Maxillary sinusitis: most common PNS infection; tenderness over cheek; opaque on X-ray"))
story.append(bp("Antrochoanal polyp: from maxillary sinus; unilateral; solitary; young males"))
story.append(bp("Ethmoidal polyps: bilateral; associated with allergy, ASA sensitivity (Samter's triad)"))
story.append(sp())

story.append(h2("Throat & Larynx"))
story.append(bp("Acute epiglottitis: H. influenzae type b; thumb sign on lateral neck X-ray; emergency airway"))
story.append(bp("Croup (laryngotracheobronchitis): parainfluenza; steeple sign on AP X-ray; barking cough"))
story.append(bp("Quinsy (peritonsillar abscess): uvula deviated away; trismus; Rx: aspiration/incision + antibiotics"))
story.append(bp("Carcinoma larynx: #1 site = glottis (hoarseness early → good prognosis); supraglottic spreads to nodes early"))
story.append(bp("Reinke's edema — smoking + voice abuse; bilateral vocal cord edema; hoarseness"))
story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════
# 16. DERMATOLOGY
# ═══════════════════════════════════════════════════════════════════════════
story.append(subject_header("16. DERMATOLOGY", "#880e4f"))
story.append(sp())

story.append(h2("Blistering Disorders"))
story.append(two_col_table([
    ["Pemphigus vulgaris", "Flaccid bullae; INTRAEPIDERMAL; acantholysis; Nikolsky +ve; anti-desmoglein 3 (IgG); Rx: systemic steroids"],
    ["Bullous pemphigoid", "Tense bullae; SUBEPIDERMAL; Nikolsky –ve; anti-BP180/BP230; elderly; Rx: steroids"],
    ["Dermatitis herpetiformis", "Intensely pruritic; elbows/knees; IgA at dermoepidermal junction; associated with celiac disease; Rx: dapsone + gluten-free diet"],
    ["Steven-Johnson syndrome", "<10% BSA mucosal + skin detachment; drug-induced; ICU care"],
    ["TEN (Lyell's)", ">30% BSA detachment; high mortality; SCORTEN score"],
]])
story.append(sp())

story.append(h2("Infections & Infestations"))
story.append(bp("Scabies: Sarcoptes scabiei; web spaces, genitalia; nocturnal itching; Rx: permethrin 5% (first line); ivermectin"))
story.append(bp("Pediculosis: lice; Rx: permethrin or malathion; nits glued to hair shaft"))
story.append(bp("Tinea versicolor: Malassezia; hypo/hyperpigmented; spaghetti and meatballs on KOH; Rx: ketoconazole shampoo"))
story.append(bp("Impetigo: S. aureus (bullous) or S. pyogenes (crusted); honey-colored crusts; Rx: fusidic acid/mupirocin; systemic if extensive"))
story.append(bp("Erysipelas: S. pyogenes; superficial dermis; clear demarcated edge; Rx: penicillin"))
story.append(bp("Cellulitis: deeper dermis/fat; ill-defined border; usually S. aureus/S. pyogenes; Rx: cloxacillin/cefazolin"))
story.append(sp())

story.append(h2("Psoriasis"))
story.append(bp("Chronic relapsing; plaques on extensor surfaces, scalp; silvery scales; Auspitz sign; Koebner phenomenon"))
story.append(bp("Nail changes: pitting (most common), onycholysis, subungual hyperkeratosis, oil drop sign"))
story.append(bp("Psoriatic arthritis: DIP joints, sausage digits (dactylitis), sacroiliitis"))
story.append(bp("Rx: topical (steroids, calcipotriol) → phototherapy (NB-UVB) → systemic (methotrexate) → biologics (anti-TNF)"))
story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════
# 17. PSYCHIATRY
# ═══════════════════════════════════════════════════════════════════════════
story.append(subject_header("17. PSYCHIATRY", "#37474f"))
story.append(sp())

story.append(h2("Key Drug Profiles"))
story.append(two_col_table([
    ["Haloperidol", "Typical antipsychotic; D2 blocker; EPS (TD, dystonia, akathisia); high potency"],
    ["Clozapine", "Atypical; most effective for refractory schizophrenia; agranulocytosis (monitor CBC)"],
    ["Olanzapine", "Atypical; weight gain, metabolic syndrome; sedating"],
    ["Lithium", "Mood stabilizer; narrow TI; monitor levels; nephrogenic DI, hypothyroidism, tremor; teratogenic (Ebstein's)"],
    ["Valproate", "Mood stabilizer; teratogenic (NTD); hepatotoxic; weight gain"],
    ["SSRIs", "1st line depression, OCD, panic; sexual dysfunction, serotonin syndrome (with MAOIs)"],
    ["TCAs", "Amitriptyline; sedating; anticholinergic; QT prolongation; lethal in overdose (wide QRS)"],
    ["Benzodiazepines", "GABA-A potentiation; tolerance/dependence; flumazenil reversal"],
    ["Disulfiram", "Acetaldehyde dehydrogenase inhibitor; aversion therapy for alcohol"],
    ["Naltrexone", "Opioid antagonist; reduces craving in alcohol + opioid dependence"],
]])
story.append(sp())

story.append(h2("DSM Diagnostic Points"))
story.append(bp("Schizophrenia: ≥2 of (delusions, hallucinations, disorganized speech, negative symptoms, disorganized behavior) for ≥6 months"))
story.append(bp("MDD: ≥5 symptoms (SIG E CAPS) for ≥2 weeks; at least one = depressed mood or anhedonia"))
story.append(mn("SIG E CAPS: Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor, Suicidal ideation"))
story.append(bp("Bipolar I: ≥1 manic episode (≥7 days); Bipolar II: hypomania + MDD"))
story.append(bp("Panic disorder: recurrent unexpected panic attacks + anticipatory anxiety"))
story.append(bp("OCD: obsessions (intrusive thoughts) + compulsions (actions); ego-dystonic; Rx: SSRIs + CBT"))
story.append(bp("PTSD: >1 month post-trauma; re-experiencing, avoidance, hyperarousal, negative cognition"))
story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════
# 18. RADIOLOGY
# ═══════════════════════════════════════════════════════════════════════════
story.append(subject_header("18. RADIOLOGY", "#004d40"))
story.append(sp())

story.append(h2("Classic X-ray / Imaging Signs"))
story.append(two_col_table([
    ["Sunburst appearance", "Osteosarcoma (aggressive periosteal reaction)"],
    ["Onion peel", "Ewing sarcoma (layers of periosteal new bone)"],
    ["Codman triangle", "Osteosarcoma (periosteum lifted by tumor)"],
    ["Ground glass opacity", "RDS/HMD, PCP, pulmonary edema, COVID-19 pneumonia"],
    ["Honeycomb lung", "IPF (UIP pattern), end-stage lung fibrosis"],
    ["Bat-wing / Butterfly opacity", "Pulmonary edema (perihilar)"],
    ["Air crescent sign", "Aspergilloma (mycetoma in cavity)"],
    ["Halo sign", "Invasive Aspergillosis (hemorrhage around fungal nodule)"],
    ["String sign of Kantor", "Crohn's disease (narrowed terminal ileum on barium)"],
    ["Lead pipe colon", "UC (loss of haustrations, rigid colon)"],
    ["Coffee bean sign", "Sigmoid volvulus (dilated loop)"],
    ["Bird beak sign", "Achalasia (narrowed LES on barium swallow)"],
    ["Double bubble sign", "Duodenal atresia (X-ray in neonate)"],
    ["Sail sign", "Thymic shadow (normal in infant CXR) OR supracondylar fracture (fat pad)"],
    ["Egg-on-side heart", "TGA (Transposition of Great Arteries)"],
    ["Boot-shaped heart", "TOF (Tetralogy of Fallot)"],
    ["Snowman / Figure of 8 heart", "TAPVC (Total Anomalous Pulmonary Venous Connection)"],
    ["Rib notching", "Coarctation of aorta (post-3rd rib, inferior border)"],
]])
story.append(PageBreak())

# ═══════════════════════════════════════════════════════════════════════════
# 19. ANAESTHESIA
# ═══════════════════════════════════════════════════════════════════════════
story.append(subject_header("19. ANAESTHESIA", "#0d47a1"))
story.append(sp())

story.append(h2("General Anaesthesia"))
story.append(two_col_table([
    ["Thiopentone", "Ultra-short acting barbiturate; induction agent; redistributes (not metabolized) for short action; contraindicated in porphyria"],
    ["Propofol", "TIVA/induction; 'milk of amnesia'; antiemetic; pain on injection; contraindicated if egg/soy allergy"],
    ["Ketamine", "NMDA antagonist; dissociative anesthesia; bronchodilator; used in asthma/shock; emergence delirium; ↑ BP/ICP"],
    ["Succinylcholine", "Depolarizing NMJ blocker; fastest onset/offset; hyperkalemia risk (burns, denervation, myopathies); malignant hyperthermia trigger"],
    ["Rocuronium", "Non-depolarizing; fastest onset among non-depolarizing; reversed by sugammadex"],
    ["Neostigmine", "Reversal of non-depolarizing block; with glycopyrrolate (anti-muscarinic)"],
    ["Halothane", "Volatile agent; sensitizes myocardium to catecholamines; hepatotoxic; malignant hyperthermia trigger"],
    ["Sevoflurane", "Most commonly used volatile in children; sweet smell; non-pungent; quick induction"],
    ["Isoflurane", "↑ cerebral blood flow least; good for neurosurgery; coronary steal possible"],
    ["Desflurane", "Fastest recovery; pungent; not used for induction; airway irritant"],
]])
story.append(sp())

story.append(h2("Regional Anaesthesia"))
story.append(bp("Spinal anaesthesia: subarachnoid space; L3-L4 or L4-L5 in adults (below L1 to avoid cord); CSF → baricity important"))
story.append(bp("Epidural: epidural space; catheter technique; larger volume; slower onset; can be topped up"))
story.append(bp("LAST (Local Anaesthetic Systemic Toxicity): perioral numbness → CNS excitation → convulsions → cardiac arrest; Rx: 20% Intralipid"))
story.append(bp("Maximum safe doses: lignocaine 3 mg/kg plain, 7 mg/kg with adrenaline; bupivacaine 2 mg/kg"))
story.append(sp())

story.append(h2("Malignant Hyperthermia"))
story.append(bp("Triggered by: succinylcholine + volatile agents (halothane, isoflurane, sevoflurane)"))
story.append(bp("Ryanodine receptor (RYR1) mutation → uncontrolled Ca²⁺ release from SR"))
story.append(bp("Features: rapid rise in temperature, masseter rigidity, ↑ CO₂, arrhythmias, rhabdomyolysis"))
story.append(bp("Treatment: STOP trigger + dantrolene sodium (specific; 2.5 mg/kg IV) + cooling"))
story.append(sp())

# FINAL PAGE — Quick Formula Reference
story.append(PageBreak())
story.append(subject_header("QUICK FORMULA & VALUES REFERENCE", "#212121"))
story.append(sp())
story.append(two_col_table([
    ["Cardiac Output", "HR × SV (normal ~5 L/min)"],
    ["MAP", "(SBP + 2×DBP) / 3 OR DBP + 1/3 pulse pressure"],
    ["Corrected QT (QTc)", "QT / √RR interval (Bazett's formula); normal <0.44s"],
    ["Anion Gap", "Na⁺ − (Cl⁻ + HCO₃⁻); normal 8-12 mEq/L"],
    ["Creatinine Clearance", "(140−age) × weight / (72 × creatinine) [×0.85 for females]"],
    ["GFR (CKD-EPI preferred)", "Normal ≥90 mL/min/1.73m²; ESKD <15"],
    ["BMI", "Weight(kg) / Height(m)²; normal 18.5-24.9"],
    ["Parkland formula", "4 × wt(kg) × %TBSA (RL); half in 1st 8h"],
    ["Apgar score", "Each of 5 criteria 0/1/2; ≥7 = normal; <4 = resuscitation"],
    ["Child-Pugh score", "Bilirubin, Albumin, PT, Ascites, Encephalopathy; A/B/C"],
    ["MELD score", "3.78 × lnBili + 11.2 × lnINR + 9.57 × lnCr + 6.43"],
    ["Ranson's criteria", "≥3 = severe pancreatitis"],
    ["Wells score (DVT)", "≥2 = high probability"],
    ["CHA₂DS₂-VASc", "≥2 in men, ≥3 in women → anticoagulate in AF"],
    ["APTT", "25-35 seconds; monitors heparin therapy"],
    ["PT/INR", "INR 1; monitors warfarin; target 2-3 for most indications"],
], col1_title="Parameter", col2_title="Value / Formula"))
story.append(sp(10))
story.append(Paragraph("Best of Luck for NEET PG 2026! You've got this.", 
    ParagraphStyle('Good', fontSize=13, fontName='Helvetica-Bold', 
    alignment=TA_CENTER, textColor=colors.HexColor('#1a237e'))))

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

cd /home/daytona/workspace/neetpg-revision && python generate_pdf.py

~/neetpg-revision/generate_pdf.py

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/neetpg-revision/generate_pdf.py'

cd /home/daytona/workspace/neetpg-revision && python generate_pdf.py 2>&1

grep -n "^\]\])" /home/daytona/workspace/neetpg-revision/generate_pdf.py

sed -i 's/^\]\])/]))/' /home/daytona/workspace/neetpg-revision/generate_pdf.py &…

python3 -c " content = open('/home/daytona/workspace/neetpg-revision/generate_pd…

python /home/daytona/workspace/neetpg-revision/generate_pdf.py 2>&1

ls -lh /home/daytona/workspace/neetpg-revision/NEET_PG_Last_Minute_Revision.pdf