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,
    HRFlowable, KeepTogether
)
from reportlab.lib.enums import TA_LEFT, TA_CENTER
from reportlab.platypus import PageBreak

OUTPUT = "/home/daytona/workspace/obs-cheatsheet/OBG_Cheatsheet_MBBS.pdf"

# ── Colour palette ──────────────────────────────────────────────────────────
NAVY   = colors.HexColor("#1A3557")
TEAL   = colors.HexColor("#117A8B")
GOLD   = colors.HexColor("#D4A017")
LGRAY  = colors.HexColor("#F2F4F7")
DGRAY  = colors.HexColor("#4A4A4A")
WHITE  = colors.white
RED    = colors.HexColor("#C0392B")
GREEN  = colors.HexColor("#1D7A4F")

# ── Styles ───────────────────────────────────────────────────────────────────
styles = getSampleStyleSheet()

def s(name, **kw):
    return ParagraphStyle(name, parent=styles["Normal"], **kw)

H1  = s("H1",  fontSize=20, textColor=WHITE,   alignment=TA_CENTER, fontName="Helvetica-Bold", spaceAfter=4)
H2  = s("H2",  fontSize=12, textColor=WHITE,   fontName="Helvetica-Bold", spaceBefore=2, spaceAfter=2)
H3  = s("H3",  fontSize=9.5,textColor=NAVY,    fontName="Helvetica-Bold", spaceBefore=3, spaceAfter=1)
H4  = s("H4",  fontSize=8.5,textColor=TEAL,    fontName="Helvetica-Bold", spaceBefore=2, spaceAfter=1)
BODY= s("BODY",fontSize=8,  textColor=DGRAY,   fontName="Helvetica",      spaceAfter=1, leading=11)
BULL= s("BULL",fontSize=8,  textColor=DGRAY,   fontName="Helvetica",      leftIndent=10, spaceAfter=1, leading=11)
KP  = s("KP",  fontSize=7.5,textColor=RED,     fontName="Helvetica-Bold", spaceAfter=1)
FOOT= s("FOOT",fontSize=7,  textColor=DGRAY,   alignment=TA_CENTER,       fontName="Helvetica-Oblique")

def b(text): return f"<b>{text}</b>"
def col(text, c): return f'<font color="{c}">{text}</font>'

# ── Helper builders ──────────────────────────────────────────────────────────

def topic_header(title, num):
    data = [[Paragraph(f"{num}. {title}", H2)]]
    t = Table(data, colWidths=[17*cm])
    t.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), NAVY),
        ("TOPPADDING", (0,0), (-1,-1), 5),
        ("BOTTOMPADDING", (0,0), (-1,-1), 5),
        ("LEFTPADDING", (0,0), (-1,-1), 8),
    ]))
    return t

def kp(text):
    return Paragraph(f"★ {text}", KP)

def bullet(text):
    return Paragraph(f"• {text}", BULL)

def sub(text):
    return Paragraph(text, H4)

def body(text):
    return Paragraph(text, BODY)

def hr():
    return HRFlowable(width="100%", thickness=0.5, color=colors.HexColor("#CCCCCC"), spaceAfter=4)

def two_col_table(rows, col1_title="", col2_title="", col1w=6*cm, col2w=11*cm):
    """Simple 2-column table."""
    header_row = None
    if col1_title or col2_title:
        header_row = [
            Paragraph(b(col1_title), s("th", fontSize=8, fontName="Helvetica-Bold", textColor=WHITE)),
            Paragraph(b(col2_title), s("th", fontSize=8, fontName="Helvetica-Bold", textColor=WHITE)),
        ]
    data = []
    if header_row:
        data.append(header_row)
    for r in rows:
        data.append([Paragraph(r[0], BODY), Paragraph(r[1], BODY)])
    t = Table(data, colWidths=[col1w, col2w])
    style = [
        ("GRID", (0,0), (-1,-1), 0.3, colors.HexColor("#AAAAAA")),
        ("BACKGROUND", (0,0), (-1,0), TEAL if header_row else LGRAY),
        ("ROWBACKGROUNDS", (0,1 if header_row else 0), (-1,-1), [WHITE, LGRAY]),
        ("TOPPADDING", (0,0), (-1,-1), 3),
        ("BOTTOMPADDING", (0,0), (-1,-1), 3),
        ("LEFTPADDING", (0,0), (-1,-1), 4),
        ("VALIGN", (0,0), (-1,-1), "TOP"),
    ]
    t.setStyle(TableStyle(style))
    return t

def three_col_table(rows, titles, widths):
    data = [[Paragraph(b(t), s("th", fontSize=8, fontName="Helvetica-Bold", textColor=WHITE)) for t in titles]]
    for r in rows:
        data.append([Paragraph(c, BODY) for c in r])
    t = Table(data, colWidths=widths)
    t.setStyle(TableStyle([
        ("GRID", (0,0), (-1,-1), 0.3, colors.HexColor("#AAAAAA")),
        ("BACKGROUND", (0,0), (-1,0), TEAL),
        ("ROWBACKGROUNDS", (0,1), (-1,-1), [WHITE, LGRAY]),
        ("TOPPADDING", (0,0), (-1,-1), 3),
        ("BOTTOMPADDING", (0,0), (-1,-1), 3),
        ("LEFTPADDING", (0,0), (-1,-1), 4),
        ("VALIGN", (0,0), (-1,-1), "TOP"),
    ]))
    return t

# ── Cover banner ─────────────────────────────────────────────────────────────
def cover_banner():
    data = [[Paragraph("OBG EXAM CHEAT SHEET", H1)],
            [Paragraph("Obstetrics &amp; Gynaecology | MBBS Final Year | Based on DC Dutta &amp; Williams", 
                       s("sub", fontSize=10, textColor=GOLD, alignment=TA_CENTER, fontName="Helvetica-Bold"))],
            [Paragraph("14 High-Yield Topics", 
                       s("sub2", fontSize=9, textColor=colors.HexColor("#BFC9D4"), alignment=TA_CENTER, fontName="Helvetica"))]]
    t = Table(data, colWidths=[17*cm])
    t.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), NAVY),
        ("TOPPADDING", (0,0), (-1,-1), 10),
        ("BOTTOMPADDING", (0,0), (-1,-1), 10),
        ("ALIGN", (0,0), (-1,-1), "CENTER"),
    ]))
    return t

# ════════════════════════════════════════════════════════════════════════════
# CONTENT
# ════════════════════════════════════════════════════════════════════════════

def build_story():
    story = []

    # ── COVER ─────────────────────────────────────────────────────────────
    story.append(cover_banner())
    story.append(Spacer(1, 0.3*cm))

    # Quick index table
    index_data = [
        [Paragraph(b("No."), BODY), Paragraph(b("Topic"), BODY), Paragraph(b("No."), BODY), Paragraph(b("Topic"), BODY)],
        [body("1"), body("APH - Overview"), body("8"), body("Intrauterine Fetal Death")],
        [body("2"), body("Placenta Previa"), body("9"), body("HTN in Pregnancy")],
        [body("3"), body("Abruptio Placentae"), body("10"), body("Endometriosis")],
        [body("4"), body("Antenatal Fetal Surveillance"), body("11"), body("Uterine Polyp")],
        [body("5"), body("Antenatal Care / Fitness"), body("12"), body("PID")],
        [body("6"), body("Malposition & Malpresentation"), body("13"), body("Fibroid")],
        [body("7"), body("Preterm Labour"), body("14"), body("Caesarean Section")],
    ]
    idx_t = Table(index_data, colWidths=[1*cm, 7.5*cm, 1*cm, 7.5*cm])
    idx_t.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,0), TEAL),
        ("TEXTCOLOR", (0,0), (-1,0), WHITE),
        ("ROWBACKGROUNDS", (0,1), (-1,-1), [WHITE, LGRAY]),
        ("GRID", (0,0), (-1,-1), 0.3, colors.HexColor("#AAAAAA")),
        ("TOPPADDING", (0,0), (-1,-1), 3), ("BOTTOMPADDING", (0,0), (-1,-1), 3),
        ("LEFTPADDING", (0,0), (-1,-1), 4),
    ]))
    story.append(idx_t)
    story.append(Spacer(1, 0.4*cm))
    story.append(hr())

    # ═══════════════════════════════════════════════
    # 1. APH
    # ═══════════════════════════════════════════════
    story.append(KeepTogether([
        topic_header("ANTEPARTUM HAEMORRHAGE (APH)", 1),
        Spacer(1, 0.15*cm),
        kp("Def: Bleeding from genital tract after 28 weeks (Dutta) / 20 weeks (Williams) before delivery"),
        Spacer(1,0.1*cm),
        sub("Causes"),
        two_col_table([
            [b("Placenta Previa"), "Painless, bright red, recurrent - placenta in LUS"],
            [b("Abruptio Placentae"), "Painful, dark, concealed - premature separation of normally sited placenta"],
            [b("Vasa Previa"), "Fetal vessels over os - fetal blood loss; associated with velamentous insertion"],
            [b("Local causes"), "Cervicitis, ectropion, polyp, varicosities, trauma"],
        ], "Cause", "Key Feature", 4*cm, 13*cm),
        Spacer(1,0.1*cm),
        sub("General Management"),
        bullet("Admit, IV access x2, CBC, G&amp;X, coagulation profile"),
        bullet("USG to locate placenta (before any PV exam)"),
        bullet("CTG continuous fetal monitoring"),
        bullet("IV fluid resuscitation; blood transfusion as needed"),
        hr(),
    ]))

    # ═══════════════════════════════════════════════
    # 2. PLACENTA PREVIA
    # ═══════════════════════════════════════════════
    story.append(KeepTogether([
        topic_header("PLACENTA PREVIA", 2),
        Spacer(1, 0.15*cm),
        kp("Def: Placenta implanted in Lower Uterine Segment (LUS), partially/completely covering internal os"),
        Spacer(1,0.1*cm),
        sub("Dutta's Classification"),
        two_col_table([
            ["Type I (Low-lying)", "In LUS but not reaching os"],
            ["Type II (Marginal)", "Reaches margin of internal os"],
            ["Type III (Partial)", "Partially covers os"],
            ["Type IV (Central / Complete)", "Completely covers os → ALWAYS LSCS"],
        ], "Type", "Description", 5*cm, 12*cm),
        Spacer(1,0.1*cm),
        sub("Clinical Features"),
        bullet("Painless, revealed, BRIGHT RED, recurrent PV bleeding"),
        bullet("Soft non-tender uterus; high presenting part / malpresentation"),
        bullet("FHS usually present; NO PV examination"),
        sub("Management"),
        two_col_table([
            [b("Expectant"), "&lt;37 wks, stable: Admit, bed rest, blood transfusion, steroids if &lt;34 wks"],
            [b("Active - Type I/II"), "Induction of labour if at term with stable mother"],
            [b("Active - Type III/IV"), "LSCS (always for Type IV)"],
            [b("Complications"), "PPH, morbidly adherent placenta (accreta/increta/percreta)"],
        ], "Approach", "Details", 3.5*cm, 13.5*cm),
        hr(),
    ]))

    # ═══════════════════════════════════════════════
    # 3. ABRUPTIO PLACENTAE
    # ═══════════════════════════════════════════════
    story.append(KeepTogether([
        topic_header("ABRUPTIO PLACENTAE", 3),
        Spacer(1, 0.15*cm),
        kp("Def: Premature separation of normally situated placenta after 20 weeks"),
        Spacer(1,0.1*cm),
        sub("Sher's Grading"),
        two_col_table([
            ["Grade 0", "Asymptomatic; diagnosed retrospectively on histology"],
            ["Grade 1", "Mild vaginal bleed; no fetal distress"],
            ["Grade 2", "Moderate; fetal distress present; uterine tenderness"],
            ["Grade 3A", "Severe; IUFD; no coagulopathy"],
            ["Grade 3B", "Severe; IUFD + DIC (coagulopathy)"],
        ], "Grade", "Features", 2.5*cm, 14.5*cm),
        Spacer(1,0.1*cm),
        sub("Clinical Features"),
        bullet("Sudden, painful (constant) PV bleeding; may be concealed"),
        bullet("Board-like rigid uterus with severe tenderness"),
        bullet("Shock disproportionate to visible blood loss (concealed)"),
        bullet("FHS absent in severe cases"),
        sub("Complications - Mnemonic: DIC-ARF-PPH"),
        two_col_table([
            [b("DIC"), "Thromboplastin release → consumption coagulopathy"],
            [b("Acute Renal Failure"), "ATN / Bilateral cortical necrosis"],
            [b("Couvelaire Uterus"), "Blood infiltrates myometrium → blue-purple, woody; may need hysterectomy"],
            [b("PPH"), "Atonic due to Couvelaire or coagulopathy"],
            [b("Sheehan's syndrome"), "Pituitary necrosis from severe shock"],
        ], "Complication", "Mechanism", 4*cm, 13*cm),
        sub("Management"),
        bullet("Mild/preterm: Expectant; close monitoring, steroids if &lt;34 wks"),
        bullet("Moderate/Severe: Immediate delivery - vaginal if fetus dead / CS if fetal distress"),
        bullet("Correct coagulopathy: FFP, cryoprecipitate, platelets"),
        hr(),
    ]))

    # ═══════════════════════════════════════════════
    # 4. ANTENATAL FETAL SURVEILLANCE
    # ═══════════════════════════════════════════════
    story.append(KeepTogether([
        topic_header("ANTENATAL FETAL SURVEILLANCE", 4),
        Spacer(1, 0.15*cm),
        kp("Goal: Detect fetal compromise before irreversible damage"),
        Spacer(1,0.1*cm),
        sub("Methods Summary"),
        two_col_table([
            [b("Fetal Movement Count (Cardiff)"), "Count to 10 movements within 12 hrs; report if &lt;10"],
            [b("Non-Stress Test (NST)"), "REACTIVE = 2 accelerations ≥15 bpm for ≥15 sec in 20 min; NON-REACTIVE = concern"],
            [b("Contraction Stress Test (CST)"), "3 contractions in 10 min; NEGATIVE (no late decels) = reassuring; POSITIVE = uteroplacental insufficiency"],
            [b("Biophysical Profile (BPP)"), "5 parameters, max score 10 (see below)"],
            [b("Modified BPP"), "NST + Amniotic Fluid Index (AFI)"],
            [b("Doppler - Umbilical artery"), "S/D ratio; Absent/Reversed EDF = severe IUGR → deliver"],
        ], "Test", "Interpretation", 4.5*cm, 12.5*cm),
        Spacer(1,0.1*cm),
        sub("BPP - Manning's Scoring (each parameter 0 or 2)"),
        three_col_table([
            ["NST", "2 accelerations in 20 min", "Non-reactive = 0"],
            ["Fetal Breathing Movements", "≥1 episode ≥30 sec in 30 min", "Absent = 0"],
            ["Fetal Movements", "≥3 discrete body/limb movements", "&lt;3 = 0"],
            ["Fetal Tone", "≥1 extension-flexion cycle", "Absent = 0"],
            ["Amniotic Fluid Volume", "≥1 pocket ≥2 cm in 2 planes", "Absent/&lt;2 cm = 0"],
        ], ["Parameter", "Normal (2)", "Abnormal (0)"], [4*cm, 6.5*cm, 6.5*cm]),
        Spacer(1,0.1*cm),
        two_col_table([
            ["Score 8-10", "Normal; reassure; repeat as indicated"],
            ["Score 6", "Equivocal - repeat in 24 hours; deliver if &gt;36 wks"],
            ["Score ≤4", "DELIVER regardless of gestational age"],
        ], "Score", "Action", 2.5*cm, 14.5*cm),
        hr(),
    ]))

    # ═══════════════════════════════════════════════
    # 5. ANTENATAL CARE
    # ═══════════════════════════════════════════════
    story.append(KeepTogether([
        topic_header("ANTENATAL CARE (ANTENATAL FITNESS)", 5),
        Spacer(1, 0.15*cm),
        kp("ANC Schedule: Every 4 wks till 28 wks → every 2 wks till 36 wks → weekly till term"),
        kp("WHO recommends minimum 8 contacts (older: 4 focused ANC visits)"),
        Spacer(1,0.1*cm),
        sub("Routine Investigations"),
        two_col_table([
            ["Blood", "Group &amp; Rh, CBC, Blood glucose (FBS), VDRL, HBsAg, HIV, Rubella IgG"],
            ["Urine", "Albumin, Sugar, Microscopy (every visit)"],
            ["USG", "10-13 wks (dating/NT), 18-20 wks (anomaly scan), 32-34 wks (growth)"],
            ["Maternal serum", "AFP (15-20 wks) for NTD; Double/Triple/Quad screen for Down's"],
        ], "Type", "Tests", 2.5*cm, 14.5*cm),
        Spacer(1,0.1*cm),
        sub("Supplementation (High-yield MCQ)"),
        two_col_table([
            [b("Folic Acid"), "5 mg/day preconception → 12 weeks (prevents NTD)"],
            [b("Iron + Folic acid"), "100 mg elemental iron + 500 mcg FA daily from 14 weeks"],
            [b("Calcium"), "500 mg twice daily from 2nd trimester (prevents pre-eclampsia)"],
            [b("Tetanus Toxoid"), "TT1 early pregnancy; TT2 at 4-8 wks after TT1 (≥36 wks before delivery)"],
        ], "Supplement", "Dose / Timing", 3.5*cm, 13.5*cm),
        hr(),
    ]))

    # ═══════════════════════════════════════════════
    # 6. MALPOSITION & MALPRESENTATION
    # ═══════════════════════════════════════════════
    story.append(KeepTogether([
        topic_header("MALPOSITION & MALPRESENTATION", 6),
        Spacer(1, 0.15*cm),
        kp("Malposition = vertex presenting but in abnormal position (e.g., OP)"),
        kp("Malpresentation = non-vertex presentation (breech, face, brow, shoulder)"),
        Spacer(1,0.1*cm),
        sub("Occipito-Posterior Position (OP) - Most common malposition"),
        bullet("ROP most common; associated with anthropoid/android pelvis"),
        bullet("Features: Prolonged labour, severe backache, early urge to push"),
        bullet("Management: Await spontaneous rotation (90%); if fails → Kielland's forceps or CS"),
        Spacer(1,0.1*cm),
        sub("Breech Presentation"),
        two_col_table([
            [b("Types"), "Frank/Extended (most common, 65%) | Complete | Footling | Knee"],
            [b("Causes"), "Prematurity (#1), placenta previa, uterine anomaly, hydrocephalus, polyhydramnios, twins"],
            [b("ECV"), "External Cephalic Version at 36-37 weeks; CI: LSCS scar, abruption, placenta previa, IUGR"],
            [b("Vaginal breech"), "Only frank breech, experienced operator, adequate pelvis, no other complications"],
            [b("LSCS"), "Footling/complete breech, primigravida, large fetus, fetal compromise, failed ECV"],
        ], "Feature", "Details", 3*cm, 14*cm),
        Spacer(1,0.1*cm),
        sub("Face, Brow &amp; Shoulder"),
        three_col_table([
            ["Face", "Mentum = denominator; Mentum anterior → vaginal possible; Mentum posterior → ALWAYS LSCS"],
            ["Brow", "Largest diameter (mento-vertical 13.5 cm); usually obstructed → LSCS; may convert"],
            ["Shoulder/Transverse", "Shoulder presents; no engagement; grand multipara, PP, tumour → ALWAYS LSCS at term"],
        ], ["Presentation", "Key Point"], [3*cm, 14*cm]),
        hr(),
    ]))

    # ═══════════════════════════════════════════════
    # 7. PRETERM LABOUR
    # ═══════════════════════════════════════════════
    story.append(KeepTogether([
        topic_header("PRETERM LABOUR", 7),
        Spacer(1, 0.15*cm),
        kp("Def: Labour between 20-37 completed weeks; #1 cause of neonatal morbidity &amp; mortality"),
        kp("Fetal fibronectin &lt;50 ng/mL → delivery UNLIKELY in 7 days (high NPV)"),
        Spacer(1,0.1*cm),
        sub("Tocolytic Agents (to gain 48 hrs for steroids)"),
        two_col_table([
            [b("1st Line: Nifedipine"), "Calcium channel blocker; oral; SE: flushing, hypotension"],
            [b("1st Line: Atosiban"), "Oxytocin receptor antagonist; IV; fewer SEs; expensive"],
            [b("Indomethacin"), "COX inhibitor; use &lt;32 weeks only; risk of premature closure of ductus arteriosus"],
            [b("Salbutamol/Ritodrine"), "Beta-2 agonists; many SEs (tachycardia, pulmonary oedema); less used now"],
            [b("Contraindications"), "Chorioamnionitis, major abruption, severe IUGR, maternal instability, &gt;34 weeks"],
        ], "Drug", "Details", 4.5*cm, 12.5*cm),
        Spacer(1,0.1*cm),
        sub("Key Interventions"),
        two_col_table([
            [b("Corticosteroids"), "Betamethasone 12 mg IM x2 (24 hrs apart) OR Dexamethasone 6 mg IM x4; 24-34 wks → fetal lung maturity"],
            [b("MgSO4"), "Neuroprotection if &lt;32 weeks (reduces cerebral palsy); 4g IV bolus → 1g/hr"],
            [b("Antibiotics"), "If PPROM: Erythromycin 250 mg QDS x10 days (ORACLE trial)"],
            [b("GBS prophylaxis"), "Penicillin G IV if GBS positive on swab"],
            [b("Cervical cerclage"), "Prophylactic if cervical incompetence (short cervix &lt;25 mm at 16-24 wks)"],
        ], "Intervention", "Details", 4*cm, 13*cm),
        hr(),
    ]))

    # ═══════════════════════════════════════════════
    # 8. IUFD
    # ═══════════════════════════════════════════════
    story.append(KeepTogether([
        topic_header("INTRAUTERINE FETAL DEATH (IUFD)", 8),
        Spacer(1, 0.15*cm),
        kp("Def: Death of fetus ≥20 weeks before complete expulsion (Stillbirth = ≥28 weeks)"),
        kp("Gold Standard Diagnosis: USG - Absent cardiac activity"),
        Spacer(1,0.1*cm),
        sub("Causes"),
        three_col_table([
            ["Maternal", "Fetal", "Placental/Cord"],
            ["Pre-eclampsia, DM, APS", "Chromosomal, anomalies", "Abruption, cord accidents"],
            ["SLE, thyroid disease", "Infections (CMV, toxo)", "Velamentous insertion"],
            ["Severe anaemia, sickle cell", "Hydrops fetalis, IUGR", "Circumvallate placenta"],
        ], ["Maternal", "Fetal", "Placental/Cord"], [5.5*cm, 5.5*cm, 6*cm]),
        Spacer(1,0.1*cm),
        sub("Radiological Signs (late, on X-ray)"),
        bullet("Spalding's sign: Overlapping skull bones (after 5-7 days)"),
        bullet("Roberts' sign: Gas in fetal vessels / heart (early putrefaction)"),
        bullet("Hyperflexion of spine; exaggerated curvature"),
        Spacer(1,0.1*cm),
        sub("Investigations After IUFD"),
        bullet("TORCH titres, VDRL, blood glucose, TFT, APS screen (anticardiolipin Ab, lupus anticoagulant)"),
        bullet("Kleihauer-Betke test (fetomaternal haemorrhage); Karyotype (if anomaly suspected)"),
        bullet("Placental histopathology; Autopsy with parental consent"),
        sub("Management"),
        bullet("If &gt;4 weeks retention → DIC risk → monitor fibrinogen (falls below 150 mg/dL)"),
        bullet("IOL: Misoprostol (PGE1) or Dinoprostone (PGE2) - method of choice"),
        bullet("Psychological support, bereavement counselling, follow-up at 6 weeks"),
        hr(),
    ]))

    # ═══════════════════════════════════════════════
    # 9. HTN IN PREGNANCY
    # ═══════════════════════════════════════════════
    story.append(KeepTogether([
        topic_header("HYPERTENSION IN PREGNANCY", 9),
        Spacer(1, 0.15*cm),
        kp("HTN in pregnancy = SBP ≥140 OR DBP ≥90 mmHg on 2 occasions ≥4 hrs apart"),
        Spacer(1,0.1*cm),
        sub("Classification"),
        two_col_table([
            [b("Gestational HTN"), "BP ≥140/90 after 20 wks, NO proteinuria; normalises &lt;12 wks postpartum"],
            [b("Pre-eclampsia"), "HTN + proteinuria (&gt;300 mg/24h or PCR ≥0.3) after 20 wks"],
            [b("Chronic HTN"), "HTN before 20 wks or pre-existing, persists &gt;12 wks postpartum"],
            [b("Superimposed PET"), "Chronic HTN + new proteinuria or worsening after 20 wks"],
            [b("Eclampsia"), "Pre-eclampsia + tonic-clonic seizures (not otherwise explained)"],
        ], "Type", "Definition", 4*cm, 13*cm),
        Spacer(1,0.1*cm),
        sub("Severe Features of Pre-eclampsia (any ONE = severe)"),
        bullet("BP ≥160/110 on 2 occasions 4 hrs apart"),
        bullet("Thrombocytopenia &lt;100,000/μL"),
        bullet("Renal insufficiency: Cr &gt;1.1 mg/dL or doubling baseline"),
        bullet("Liver: LFTs &gt;2x normal, severe epigastric/RUQ pain"),
        bullet("Pulmonary oedema; New headache unresponsive to medication; Visual disturbances"),
        Spacer(1,0.1*cm),
        sub("HELLP Syndrome"),
        kp("H = Haemolysis | EL = Elevated Liver enzymes | LP = Low Platelets"),
        bullet("Epigastric pain, nausea, vomiting; Serious complication → deliver regardless of GA"),
        Spacer(1,0.1*cm),
        sub("Antihypertensives in Pregnancy"),
        two_col_table([
            [b("Labetalol"), "1st line (oral and IV); alpha + beta blocker"],
            [b("Methyldopa"), "Safe, widely used; oral; used in chronic HTN"],
            [b("Nifedipine"), "Oral calcium channel blocker; 2nd line"],
            [b("Hydralazine IV"), "Acute severe HTN; vasodilator"],
            [b("AVOID"), "ACE inhibitors, ARBs (teratogenic in 2nd/3rd trimester)"],
        ], "Drug", "Notes", 3.5*cm, 13.5*cm),
        Spacer(1,0.1*cm),
        sub("MgSO4 (Seizure Prophylaxis &amp; Treatment)"),
        bullet("Pritchard regimen: 4g IV + 5g IM each buttock (loading) → 5g IM q4h (maintenance)"),
        bullet("Sibai regimen: 6g IV bolus → 2g/hr infusion"),
        bullet("Toxicity: Loss of DTRs → Respiratory arrest → Cardiac arrest"),
        kp("MgSO4 ANTIDOTE = 10 mL of 10% Calcium Gluconate IV"),
        sub("Definitive Treatment = DELIVERY"),
        bullet("Mild: at 37 weeks | Severe features: at 34 weeks | Eclampsia/HELLP: Immediate"),
        hr(),
    ]))

    # ═══════════════════════════════════════════════
    # 10. ENDOMETRIOSIS
    # ═══════════════════════════════════════════════
    story.append(KeepTogether([
        topic_header("ENDOMETRIOSIS", 10),
        Spacer(1, 0.15*cm),
        kp("Def: Functional endometrial glands + stroma OUTSIDE the uterine cavity"),
        kp("Gold Standard Diagnosis: Laparoscopy + biopsy"),
        Spacer(1,0.1*cm),
        sub("Pathogenesis"),
        bullet("Sampson's theory (retrograde menstruation) - most accepted"),
        bullet("Coelomic metaplasia (Meyer's theory); Lymphovascular spread"),
        sub("Common Sites: Ovaries (#1) > Uterosacral ligaments > POD > Bladder > Bowel"),
        sub("Clinical Features - The 3 Ds"),
        two_col_table([
            [b("Dysmenorrhoea"), "Progressive, secondary (worsens each cycle) - HALLMARK"],
            [b("Dyspareunia"), "Deep dyspareunia (posterior fornix, uterosacral involvement)"],
            [b("Dyschezia"), "Painful defaecation - bowel involvement"],
            [b("Infertility"), "20-40% of infertile women have endometriosis"],
            [b("Signs"), "Retroverted fixed uterus, nodularity in POD/uterosacral ligaments, tender adnexa"],
        ], "Feature", "Details", 3.5*cm, 13.5*cm),
        Spacer(1,0.1*cm),
        sub("ASRM Staging"),
        two_col_table([
            ["Stage I (Minimal)", "Superficial peritoneal implants"],
            ["Stage II (Mild)", "Deeper implants, small endometriomas"],
            ["Stage III (Moderate)", "Endometriomas, peritubal/periovarian adhesions"],
            ["Stage IV (Severe)", "Large endometriomas, dense adhesions, severe distortion of anatomy"],
        ], "Stage", "Description", 3.5*cm, 13.5*cm),
        Spacer(1,0.1*cm),
        sub("Treatment"),
        two_col_table([
            [b("NSAIDs / COX inhibitors"), "Symptom relief (pain)"],
            [b("Combined OCP"), "Continuous pill - suppresses menstruation"],
            [b("Progestins"), "Norethisterone, MPA, Dienogest (1st line for pain)"],
            [b("GnRH agonists"), "Leuprolide - induces pseudomenopause; use with add-back therapy; max 6 months"],
            [b("Danazol"), "Androgenic; effective but SE (virilisation, dyslipidaemia) limit use"],
            [b("LNG-IUS (Mirena)"), "Effective for dysmenorrhoea and pelvic pain"],
            [b("Conservative surgery"), "Laparoscopic excision/ablation of implants; drain endometrioma &gt;4 cm"],
            [b("Definitive surgery"), "TAH + BSO - for severe disease, completed family; medical treatment after if &lt;50 yrs"],
        ], "Treatment", "Notes", 4.5*cm, 12.5*cm),
        hr(),
    ]))

    # ═══════════════════════════════════════════════
    # 11. UTERINE POLYP
    # ═══════════════════════════════════════════════
    story.append(KeepTogether([
        topic_header("UTERINE / ENDOMETRIAL POLYP", 11),
        Spacer(1, 0.15*cm),
        kp("Def: Focal overgrowth of endometrium containing glands, stroma &amp; blood vessels on a stalk"),
        Spacer(1,0.1*cm),
        sub("Clinical Features"),
        bullet("Intermenstrual bleeding (IMB) - most common presentation"),
        bullet("Postcoital bleeding; Menorrhagia; Postmenopausal bleeding (must exclude malignancy)"),
        bullet("Usually asymptomatic; incidental finding on USG"),
        bullet("May cause infertility (mechanical obstruction of ostia)"),
        sub("Investigations"),
        bullet("TVS (Transvaginal USG): Echogenic mass in endometrial cavity"),
        bullet("SIS (Saline Infusion Sonography): Better delineation of submucous lesion"),
        bullet("Hysteroscopy + biopsy: GOLD STANDARD - direct visualisation"),
        sub("Treatment"),
        bullet("Hysteroscopic polypectomy (resection) - treatment of choice"),
        bullet("Small asymptomatic polyps may regress spontaneously"),
        bullet("Histopathology mandatory - exclude endometrial carcinoma"),
        kp("Malignant transformation rare (~0.5%) but always send for histology"),
        hr(),
    ]))

    # ═══════════════════════════════════════════════
    # 12. PID
    # ═══════════════════════════════════════════════
    story.append(KeepTogether([
        topic_header("PELVIC INFLAMMATORY DISEASE (PID)", 12),
        Spacer(1, 0.15*cm),
        kp("Def: Infection of upper female genital tract (endometrium, tubes, ovaries, peritoneum)"),
        kp("CDC Minimum Diagnosis: ANY ONE of - Uterine tenderness / Adnexal tenderness / CET"),
        Spacer(1,0.1*cm),
        sub("Organisms"),
        bullet("Neisseria gonorrhoeae; Chlamydia trachomatis (most important STI pathogens)"),
        bullet("Anaerobes, E. coli, Mycoplasma hominis, Gardnerella (polymicrobial)"),
        sub("Clinical Features"),
        two_col_table([
            ["Lower abdominal pain", "Bilateral, constant, dull; worse with movement"],
            ["Vaginal discharge", "Purulent, malodorous"],
            ["Fever", "&gt;38.3°C; with cervical excitation tenderness (CET)"],
            ["Dyspareunia", "Deep; recent onset"],
            ["Fitz-Hugh-Curtis", "Perihepatitis; RUQ pain + tenderness; violin-string adhesions on laparoscopy"],
        ], "Feature", "Detail", 3.5*cm, 13.5*cm),
        Spacer(1,0.1*cm),
        sub("Complications (Mnemonic: FICHES)"),
        bullet("F = Fitz-Hugh-Curtis syndrome; I = Infertility (tubal factor); C = Chronic pelvic pain"),
        bullet("H = Hydrosalpinx; E = Ectopic pregnancy; S = Salpingitis / TOA (tubo-ovarian abscess)"),
        Spacer(1,0.1*cm),
        sub("Treatment (CDC 2021)"),
        two_col_table([
            [b("Outpatient"), "Ceftriaxone 500 mg IM STAT + Doxycycline 100 mg BD × 14 days + Metronidazole 500 mg BD × 14 days"],
            [b("Inpatient indications"), "Surgical emergency cannot be excluded, TOA, no oral tolerance, failure of outpatient Rx, pregnancy"],
            [b("Inpatient Regimen A"), "Cefoxitin 2g IV q6h + Doxycycline 100 mg q12h → oral doxy to complete 14 days"],
            [b("Inpatient Regimen B"), "Clindamycin 900 mg IV q8h + Gentamicin 2 mg/kg load → 1.5 mg/kg q8h"],
        ], "Setting", "Regimen", 4*cm, 13*cm),
        hr(),
    ]))

    # ═══════════════════════════════════════════════
    # 13. FIBROID
    # ═══════════════════════════════════════════════
    story.append(KeepTogether([
        topic_header("UTERINE FIBROID (LEIOMYOMA)", 13),
        Spacer(1, 0.15*cm),
        kp("Most common pelvic tumour in women; benign smooth muscle tumour"),
        kp("Malignant change to leiomyosarcoma: &lt;1%"),
        Spacer(1,0.1*cm),
        sub("Types by Location"),
        two_col_table([
            [b("Intramural"), "Most common type; within myometrium"],
            [b("Subserosal"), "Under serosa; can become pedunculated; less bleeding"],
            [b("Submucous"), "Under endometrium; MOST symptomatic - causes heavy menorrhagia"],
            [b("Cervical"), "Rare; can obstruct labour or urinary tract"],
            [b("Broad ligament/Parasitic"), "Between leaves of broad ligament; parasitic = detached, gets blood supply elsewhere"],
        ], "Type", "Features", 3.5*cm, 13.5*cm),
        Spacer(1,0.1*cm),
        sub("Clinical Features"),
        bullet("Menorrhagia (heavy regular bleeding) - esp. submucous"),
        bullet("Pelvic pressure: urinary frequency (anterior), constipation (posterior)"),
        bullet("Dysmenorrhoea, dyspareunia, infertility, recurrent miscarriage"),
        bullet("Uterine enlargement: irregular, firm, non-tender, 'cobblestone' surface"),
        Spacer(1,0.1*cm),
        sub("Degenerations (Mnemonic: HRCCS)"),
        two_col_table([
            [b("Hyaline"), "Most common; fibrous tissue replaces smooth muscle"],
            [b("Red / Carneous"), "Pregnancy-related; acute pain + fever in 2nd trimester; Rx = analgesics (conservative)"],
            [b("Cystic"), "Post-hyaline; fluid-filled spaces"],
            [b("Calcific"), "Post-menopause; 'womb stone' on X-ray"],
            [b("Sarcomatous"), "Malignant change; &lt;1%; rapid growth, irregular vascularity"],
        ], "Type", "Features", 3*cm, 14*cm),
        Spacer(1,0.1*cm),
        sub("Fibroid in Pregnancy"),
        bullet("Red degeneration (most common complication in pregnancy) → analgesics, bed rest"),
        bullet("Increased risk: preterm labour, malpresentation, placenta previa, PPH, CS"),
        sub("Treatment"),
        two_col_table([
            [b("Medical"), "GnRH agonists (Leuprolide) - shrink by 40%; pre-op use; Tranexamic acid, NSAIDs for symptoms; Ulipristal acetate (SPRM)"],
            [b("Myomectomy"), "Surgical removal of fibroid; preserves uterus; for fertility; laparoscopic or open"],
            [b("Hysterectomy"), "Definitive treatment; for completed family with severe/multiple fibroids"],
            [b("UAE"), "Uterine Artery Embolisation; preserves uterus; interventional radiology; not for those planning pregnancy"],
            [b("MRgFUS"), "MRI-guided Focused Ultrasound Surgery - non-invasive; limited availability"],
        ], "Approach", "Details", 3.5*cm, 13.5*cm),
        hr(),
    ]))

    # ═══════════════════════════════════════════════
    # 14. CAESAREAN SECTION
    # ═══════════════════════════════════════════════
    story.append(KeepTogether([
        topic_header("CAESAREAN SECTION (LSCS)", 14),
        Spacer(1, 0.15*cm),
        kp("Def: Delivery of fetus ≥28 weeks through laparotomy + hysterotomy incisions"),
        kp("Most common incision: Pfannenstiel (skin) + Transverse LUS (uterus)"),
        Spacer(1,0.1*cm),
        sub("Types"),
        two_col_table([
            [b("LSCS"), "Most common; transverse incision in lower uterine segment; less bleeding, better healing"],
            [b("Classical CS"), "Vertical incision in upper segment; risk of scar rupture in next pregnancy; used for preterm, transverse lie, anterior placenta previa"],
            [b("Perimortem CS"), "Within 4-5 minutes of maternal cardiac arrest; improves maternal resuscitation"],
        ], "Type", "Features", 3.5*cm, 13.5*cm),
        Spacer(1,0.1*cm),
        sub("Indications"),
        three_col_table([
            [b("Absolute"), b("Relative"), b("Fetal")],
            ["CPD", "LSCS on request", "Severe fetal distress"],
            ["PP Type III/IV", "Previous 2 LSCS", "Cord prolapse (live fetus)"],
            ["Prev. classical scar", "Breech in primigravida", "Malpresentation (brow, shoulder)"],
            ["Obstructed labour", "PET with unfavourable cx", "IUGR with abnormal Doppler"],
            ["Pelvic tumour blocking", "DM with macrosomia", "Active HSV at term"],
        ], ["Absolute", "Relative", "Fetal"], [5.5*cm, 5.5*cm, 6*cm]),
        Spacer(1,0.1*cm),
        sub("Complications"),
        two_col_table([
            [b("Immediate"), "Haemorrhage; bladder/ureter/bowel injury; anaesthetic complications; visceral adhesions"],
            [b("Short term"), "Wound infection; endometritis; ileus; DVT/PE; urinary retention"],
            [b("Long term"), "Uterine scar rupture in future pregnancy; placenta accreta spectrum; adhesions; infertility"],
        ], "Timing", "Complications", 3*cm, 14*cm),
        Spacer(1,0.1*cm),
        sub("VBAC (Vaginal Birth After Caesarean)"),
        bullet("Eligible: 1 previous LSCS, transverse LUS scar, no recurrent indication, adequate pelvis"),
        bullet("Success rate: 60-80%"),
        bullet("Risk: Uterine scar dehiscence/rupture (0.5-1%); continuous CTG monitoring mandatory"),
        kp("VBAC contraindicated: Previous classical scar, previous uterine rupture, 3+ LSCS"),
        hr(),
    ]))

    # ═══════════════════════════════════════════════
    # QUICK MCQ REVISION TABLE
    # ═══════════════════════════════════════════════
    story.append(PageBreak())
    banner_data = [[Paragraph("QUICK MCQ REVISION - HIGH YIELD FACTS", H1)]]
    banner_t = Table(banner_data, colWidths=[17*cm])
    banner_t.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), TEAL),
        ("TOPPADDING", (0,0), (-1,-1), 8),
        ("BOTTOMPADDING", (0,0), (-1,-1), 8),
    ]))
    story.append(banner_t)
    story.append(Spacer(1, 0.2*cm))

    mcq_rows = [
        ["APH Definition", "After 28 weeks - Dutta / After 20 weeks - Williams"],
        ["Placenta Previa Type IV", "ALWAYS LSCS; no attempt at vaginal delivery"],
        ["Abruption complication", "DIC + Couvelaire uterus + ARF; Couvelaire = blood infiltrates myometrium"],
        ["BPP Score ≤4", "Deliver immediately regardless of gestational age"],
        ["NST Reactive", "2 accelerations ≥15 bpm for ≥15 sec in 20 minutes"],
        ["Umbilical Doppler", "Absent/Reversed EDF in UA = severe IUGR; deliver"],
        ["Folic acid in ANC", "5 mg/day from preconception to 12 weeks (prevents NTD)"],
        ["TT vaccination", "TT1 early; TT2 at 4-8 weeks after TT1 (≥36 weeks before EDD)"],
        ["OP position", "Most common malposition; ROP most common; causes prolonged labour, backache"],
        ["Mentum posterior face", "Cannot deliver vaginally - ALWAYS LSCS"],
        ["Brow presentation", "Largest diameter (mento-vertical 13.5 cm) - usually LSCS"],
        ["Tocolysis 1st line", "Nifedipine OR Atosiban"],
        ["Corticosteroids", "Betamethasone 12 mg IM x2; 24-34 weeks; 24 hrs apart"],
        ["MgSO4 <32 weeks", "Neuroprotection against cerebral palsy (not just seizure prophylaxis)"],
        ["IUFD gold standard", "USG: absent cardiac activity"],
        ["Spalding's sign", "Overlapping skull bones on X-ray after 5-7 days of IUFD"],
        ["IUFD retention >4 wks", "DIC risk; fibrinogen falls; monitor coagulation"],
        ["Preeclampsia Rx", "Definitive = Delivery; MgSO4 for seizure prophylaxis; Labetalol for BP"],
        ["MgSO4 antidote", "10 mL of 10% Calcium Gluconate IV"],
        ["HELLP syndrome", "Haemolysis + Elevated Liver enzymes + Low Platelets; deliver regardless of GA"],
        ["Endometriosis Dx", "Laparoscopy + biopsy (Gold Standard)"],
        ["Endometriosis staging", "ASRM I-IV; Chocolate cyst = endometrioma = Stage III"],
        ["Endometriosis CA-125", "Elevated but non-specific; used for monitoring response to treatment"],
        ["Polyp diagnosis", "Hysteroscopy + biopsy (Gold Standard)"],
        ["Polyp malignancy", "~0.5% malignant transformation; always histopathology"],
        ["PID minimum criteria", "ANY ONE: Uterine / Adnexal / Cervical excitation tenderness"],
        ["PID outpatient Rx", "Ceftriaxone 500 mg IM + Doxy 100 mg BD + Metronidazole 500 mg BD x14 days"],
        ["Fitz-Hugh-Curtis", "Perihepatitis in PID; violin-string adhesions on laparoscopy"],
        ["Fibroid most symptomatic", "Submucous fibroid - causes worst menorrhagia"],
        ["Red degeneration", "In pregnancy (2nd trimester); pain + fever; Rx = analgesics only (conservative)"],
        ["Fibroid Rx (fertility)", "Myomectomy preserves uterus; UAE contraindicated if planning pregnancy"],
        ["LSCS incision", "Pfannenstiel skin incision; Transverse LUS uterine incision"],
        ["VBAC criteria", "1 previous LSCS + transverse LUS scar + no recurrent indication + continuous CTG"],
        ["VBAC contraindication", "Previous classical CS scar / previous uterine rupture / 3+ previous LSCS"],
        ["Twins - Hellin's law", "Twins 1:80; Triplets 1:80²; Quads 1:80³"],
        ["TTTS", "Twin-Twin Transfusion Syndrome; only in MCDA twins; Rx = laser ablation of anastomoses"],
        ["Multiple pregnancy chorion", "DCDA: lambda/twin-peak sign; MCDA: T-sign on USG"],
        ["ECV timing", "36-37 weeks; CI = previous LSCS scar, placenta previa, IUGR, abruption"],
    ]

    for row in mcq_rows:
        story.append(two_col_table(
            [[b(row[0]), row[1]]],
            col1w=6*cm, col2w=11*cm
        ))

    # Footer
    story.append(Spacer(1, 0.5*cm))
    story.append(Paragraph(
        "Sources: DC Dutta's Textbook of Obstetrics (9th ed.) | DC Dutta's Gynaecology (7th ed.) | "
        "Williams Obstetrics (25th ed.) | Berek &amp; Novak's Gynecology | Creasy &amp; Resnik's Maternal-Fetal Medicine",
        FOOT
    ))

    return story


# ── Build PDF ─────────────────────────────────────────────────────────────────
def on_page(canvas, doc):
    canvas.saveState()
    canvas.setFont("Helvetica", 7)
    canvas.setFillColor(colors.HexColor("#999999"))
    canvas.drawCentredString(A4[0]/2, 1.0*cm, f"OBG Cheat Sheet | MBBS Exam Revision | Page {doc.page}")
    canvas.restoreState()

doc = SimpleDocTemplate(
    OUTPUT,
    pagesize=A4,
    rightMargin=2*cm, leftMargin=2*cm,
    topMargin=1.5*cm, bottomMargin=1.5*cm,
    title="OBG MBBS Exam Cheat Sheet",
    author="Orris"
)

story = build_story()
doc.build(story, onFirstPage=on_page, onLaterPages=on_page)
print(f"PDF generated: {OUTPUT}")