const pptxgen = require('pptxgenjs');

const pptx = new pptxgen();
pptx.layout = 'LAYOUT_WIDE';
pptx.author = 'Orris';
pptx.subject = 'Hepatobiliary Radiology OSCE Cases';
pptx.title = 'Hepatobiliary Radiology OSCE Cases for PG Exams';
pptx.company = 'Radiology Teaching';
pptx.lang = 'en-US';
pptx.theme = {
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  bodyFontFace: 'Calibri',
  lang: 'en-US'
};

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function addCaseSlide(caseNo, title, vignette, findings, diagnosis, ddx, nextStep, pearl, source) {
  const slide = pptx.addSlide();
  addHeader(slide, `Case ${caseNo}: ${title}`, 'OSCE Station: Interpret imaging pattern and provide most likely diagnosis');

  slide.addText('Clinical Vignette', {
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  slide.addText('Most Likely Diagnosis', {
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  slide.addText(diagnosis, {
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  slide.addText('Key Differentials', {
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  slide.addText('Next Best Radiology Step', {
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  slide.addText(nextStep, {
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  slide.addText('Exam Pearl', {
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let slide = pptx.addSlide();
addHeader(slide, 'Hepatobiliary Radiology OSCE Cases (15 Stations)', 'For Postgraduate Exam Preparation');
slide.addText('Coverage includes common + high-yield hepatobiliary imaging diagnoses', {
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slide.addText([
  { text: '• Gallbladder and biliary emergencies\n', options: { breakLine: true } },
  { text: '• Benign and malignant focal liver lesions\n', options: { breakLine: true } },
  { text: '• Diffuse biliary disease and obstructive patterns\n', options: { breakLine: true } },
  { text: '• Typical OSCE approach: pattern recognition + differential + next step' }
], {
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slide.addText('Textbook base: Grainger & Allison\'s Diagnostic Radiology', {
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});

slide = pptx.addSlide();
addHeader(slide, 'How to Use This Deck in OSCE Practice');
slide.addText([
  { text: '1. Read vignette in 20 seconds\n', options: { breakLine: true } },
  { text: '2. State key imaging signs in one structured sentence\n', options: { breakLine: true } },
  { text: '3. Give most likely diagnosis + 2 differentials\n', options: { breakLine: true } },
  { text: '4. Mention one confirmatory test / next imaging step\n', options: { breakLine: true } },
  { text: '5. Add one management-relevant radiology point' }
], {
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addCaseSlide(
  1,
  'Acute Calculous Cholecystitis',
  '45-year-old woman with fever, RUQ pain, vomiting, positive Murphy sign.',
  'US: gallstones, GB wall >3 mm, pericholecystic fluid, distension >5 cm. Possible impacted neck stone.',
  'Acute calculous cholecystitis',
  'Biliary colic\nAcalculous cholecystitis\nGB wall edema from hepatitis/CHF',
  'Ultrasound first-line. Evaluate CBD if cholestatic LFTs to rule out choledocholithiasis.',
  'Stones + sonographic Murphy sign and wall thickening carries high predictive value for acute cholecystitis.',
  'Grainger & Allison\'s Diagnostic Radiology, p. 598-599'
);

addCaseSlide(
  2,
  'Gangrenous Cholecystitis',
  'Elderly diabetic patient with severe pain then paradoxical reduction in tenderness.',
  'US/CT: irregular asymmetric GB wall thickening, sloughed intraluminal membranes, pericholecystic fluid ± intramural gas.',
  'Gangrenous cholecystitis',
  'Complicated acute cholecystitis\nEmphysematous cholecystitis\nGB perforation',
  'Urgent contrast CT to assess complications; immediate surgical referral.',
  'Clinical signs may deceptively improve while ischemic necrosis progresses.',
  'Grainger & Allison\'s Diagnostic Radiology, p. 599'
);

addCaseSlide(
  3,
  'Gallbladder Carcinoma',
  '62-year-old female with weight loss, progressive jaundice, RUQ discomfort.',
  'Imaging may show irregular focal/diffuse GB wall thickening or mass replacing GB fossa, often with stones and adjacent liver invasion.',
  'Gallbladder carcinoma',
  'Xanthogranulomatous cholecystitis\nMetastatic lesion\nAdenomyomatosis',
  'Contrast CT/MRI for local spread, nodal disease and resectability mapping.',
  'Liver segments 4/5 invasion and early nodal spread around portal region are common.',
  'Grainger & Allison\'s Diagnostic Radiology, p. 602'
);

addCaseSlide(
  4,
  'Hilar Cholangiocarcinoma (Klatskin Tumour)',
  '58-year-old with painless progressive obstructive jaundice and pruritus.',
  'MRCP: hilar stricture with intrahepatic biliary dilatation and non-dilated distal CBD. CT may show subtle isodense hilar mass.',
  'Perihilar cholangiocarcinoma',
  'Benign hilar stricture\nPSC-related dominant stricture\nIgG4 cholangitis',
  'MRCP + multiphasic CT for proximal extent, vascular involvement, and surgical planning.',
  'MRCP is key for mapping ductal extent that determines operability.',
  'Grainger & Allison\'s Diagnostic Radiology, p. 612-613'
);

addCaseSlide(
  5,
  'Primary Sclerosing Cholangitis (PSC)',
  'Young male with inflammatory bowel disease and cholestatic enzymes.',
  'MRCP/ERCP: multifocal short strictures with alternating normal/mildly dilated segments giving beaded appearance.',
  'Primary sclerosing cholangitis',
  'Recurrent pyogenic cholangitis\nIgG4 sclerosing cholangitis\nSecondary sclerosing cholangitis',
  'MRCP for noninvasive diagnosis and longitudinal surveillance for dominant strictures/cholangiocarcinoma.',
  'Dominant stricture in PSC warrants close evaluation to exclude superimposed cholangiocarcinoma.',
  'Grainger & Allison\'s Diagnostic Radiology, p. 607'
);

addCaseSlide(
  6,
  'Hydatid Cyst of Liver',
  '35-year-old from endemic area with dull RUQ pain and cystic liver lesion.',
  'US/CT: cyst with daughter cysts, hydatid sand/debris, detached membranes, or wall calcification.',
  'Hepatic echinococcosis (hydatid disease)',
  'Simple hepatic cyst\nBiliary cystadenoma\nNecrotic metastasis',
  'Correlate serology; define complexity with CT/MRI before intervention.',
  'Daughter cysts + membrane detachment strongly suggest hydatid disease.',
  'Grainger & Allison\'s Diagnostic Radiology, p. 634'
);

addCaseSlide(
  7,
  'Pyogenic Liver Abscess',
  'Patient with fever, leukocytosis, sepsis and tender hepatomegaly.',
  'US: evolving from ill-defined low reflectivity lesion to thick-walled cavity with internal echoes. CT: low-attenuation lesion with rim enhancement.',
  'Hepatic abscess',
  'Necrotic metastasis\nInfected cyst\nBiloma',
  'Image-guided aspiration/drainage for diagnosis + therapy, with microbiology.',
  'Early abscess can mimic solid tumour; intervention often confirms diagnosis.',
  'Grainger & Allison\'s Diagnostic Radiology, p. 634'
);

addCaseSlide(
  8,
  'Haemangioma',
  'Incidental liver lesion in asymptomatic woman, no chronic liver disease.',
  'MRI: markedly T2 hyperintense lesion, peripheral nodular arterial enhancement with progressive centripetal fill-in.',
  'Cavernous haemangioma',
  'Hypervascular metastasis\nHCC\nFNH',
  'Dynamic contrast MRI is most specific when enhancement pattern is classic.',
  'Persistent delayed fill-in matching blood pool supports haemangioma.',
  'Grainger & Allison\'s Diagnostic Radiology, p. 633-636'
);

addCaseSlide(
  9,
  'Focal Nodular Hyperplasia (FNH)',
  'Young woman with incidentally detected solid liver lesion, no cirrhosis.',
  'CT/MRI: well-defined arterial hyperenhancing lesion, often with central stellate scar; usually no necrosis/calcification.',
  'Focal nodular hyperplasia',
  'Hepatocellular adenoma\nFibrolamellar HCC\nHypervascular metastasis',
  'Hepatocyte-specific contrast MRI helps distinguish FNH from adenoma.',
  'Central scar is helpful but not universal; integrate enhancement behavior and clinical context.',
  'Grainger & Allison\'s Diagnostic Radiology, p. 636-637'
);

addCaseSlide(
  10,
  'Hepatocellular Carcinoma in Cirrhosis',
  '58-year-old with hepatitis C cirrhosis, rising AFP, new liver nodule.',
  'Multiphasic CT/MRI: arterial phase hyperenhancement with portal/equilibrium washout and capsule appearance.',
  'Hepatocellular carcinoma',
  'Dysplastic/regenerative nodule\nIntrahepatic cholangiocarcinoma\nHypervascular metastasis',
  'Perform dedicated multiphasic liver protocol; evaluate vascular invasion and multifocality.',
  'Classic arterial hyperenhancement + washout pattern is hallmark of HCC in appropriate background liver.',
  'Grainger & Allison\'s Diagnostic Radiology, p. 644-650'
);

addCaseSlide(
  11,
  'Fibrolamellar Carcinoma',
  '22-year-old without cirrhosis presenting with large solitary hepatic mass.',
  'Large lobulated mass with central fibrous scar, possible punctate scar calcification; mosaic enhancement pattern.',
  'Fibrolamellar carcinoma',
  'FNH\nConventional HCC\nHepatic adenoma',
  'Contrast MRI/CT and staging imaging; correlate age and non-cirrhotic liver status.',
  'Central scar calcification favors fibrolamellar carcinoma over typical FNH/HCC.',
  'Grainger & Allison\'s Diagnostic Radiology, p. 649'
);

addCaseSlide(
  12,
  'Colorectal Liver Metastases',
  'Known colorectal carcinoma patient with rising CEA on follow-up.',
  'Multiple focal liver lesions, often peripheral; dynamic CT/MRI and DWI improve detection and staging.',
  'Liver metastases',
  'Multifocal HCC\nAbscesses\nBiliary hamartomas (in tiny cystic lesions)',
  'Triphasic CT or liver MRI with DWI for resectability and treatment planning.',
  'In oncology OSCE, always mention lesion number, segmental distribution, and vascular relation for surgery.',
  'Grainger & Allison\'s Diagnostic Radiology, p. 781'
);

addCaseSlide(
  13,
  'Biliary Hamartomas',
  'Asymptomatic patient with numerous small liver lesions incidentally detected.',
  'US may appear heterogeneous and mimic infiltration. MRI/MRCP shows multiple tiny non-communicating cystic lesions.',
  'Biliary hamartomas (von Meyenburg complexes)',
  'Miliary metastases\nMicroabscesses\nPolycystic liver disease',
  'MRI with heavily T2-weighted sequences/MRCP to confirm benign cystic nature.',
  'These benign lesions can mimic metastases on ultrasound and CT if not recognized.',
  'Grainger & Allison\'s Diagnostic Radiology, p. 645'
);

addCaseSlide(
  14,
  'Biliary Atresia (Pediatric)',
  '2-month-old infant with persistent jaundice, pale stools, hepatomegaly.',
  'Ultrasound may show absent/abnormal gallbladder and signs of obstructive cholangiopathy; MRCP/hepatobiliary studies aid evaluation.',
  'Biliary atresia',
  'Neonatal hepatitis\nCholedochal cyst\nAlagille spectrum',
  'Prompt imaging pathway and surgical referral to avoid delay in portoenterostomy.',
  'Timing is critical because delayed diagnosis worsens long-term hepatic outcome.',
  'Grainger & Allison\'s Diagnostic Radiology, p. 891'
);

addCaseSlide(
  15,
  'Post-operative Biliary Leak / Injury',
  'Patient after cholecystectomy with pain, fever, rising bilirubin.',
  'Collection near GB fossa or subhepatic space, biliary dilatation or extravasation on cholangiographic imaging.',
  'Bile leak due to iatrogenic bile duct injury',
  'Biloma without active leak\nAbscess\nRetained CBD stone with cholangitis',
  'MRCP for ductal anatomy; interventional cholangiography for diagnosis + drainage/stenting.',
  'OSCE point: mention both diagnosis and immediate image-guided therapeutic role.',
  'Grainger & Allison\'s Diagnostic Radiology, p. 610-611'
);

slide = pptx.addSlide();
addHeader(slide, 'Rapid-Fire OSCE Checklist (Hepatobiliary)');
slide.addText([
  { text: 'Describe lesion by organ, segment, and pattern (solid/cystic/ductal)\n', options: { breakLine: true } },
  { text: 'State enhancement behavior across phases\n', options: { breakLine: true } },
  { text: 'Call out red flags: vascular invasion, obstruction level, multifocality\n', options: { breakLine: true } },
  { text: 'Provide one best diagnosis + 2 focused differentials\n', options: { breakLine: true } },
  { text: 'End with actionable next step (MRCP, multiphasic MRI, intervention)' }
], {
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});

slide = pptx.addSlide();
addHeader(slide, 'Reference');
slide.addText('Primary textbook source used for all cases:', {
  x: 0.8, y: 1.4, w: 12, h: 0.5, fontSize: 18, color: COLORS.white
});
slide.addText('Grainger & Allison\'s Diagnostic Radiology: A Textbook of Medical Imaging (ISBN: 9780323760751)', {
  x: 0.8, y: 2.0, w: 12, h: 0.6, fontSize: 16, bold: true, color: COLORS.accent
});
slide.addText('Case details adapted for OSCE teaching format for postgraduate radiology examination practice.', {
  x: 0.8, y: 2.8, w: 12, h: 0.5, fontSize: 13, color: COLORS.text, italic: true
});

pptx.writeFile({ fileName: '/home/daytona/workspace/hepatobiliary-osce/Hepatobiliary_Radiology_OSCE_15_Cases.pptx' });