from reportlab.lib.pagesizes import A4
from reportlab.lib import colors
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.units import mm, cm
from reportlab.platypus import (
    SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle,
    HRFlowable, KeepTogether, PageBreak
)
from reportlab.lib.enums import TA_LEFT, TA_CENTER, TA_JUSTIFY
from reportlab.platypus import FrameBreak
from reportlab.lib.colors import HexColor

# ── Colour palette ──────────────────────────────────────────────────────────
C_NAVY    = HexColor("#1A237E")   # dark navy  – main headers
C_BLUE    = HexColor("#1565C0")   # mid blue   – section headers
C_LTBLUE  = HexColor("#E3F2FD")   # pale blue  – header bg
C_TEAL    = HexColor("#00695C")   # teal       – subheads
C_AMBER   = HexColor("#FF8F00")   # amber      – risk / warning
C_RED     = HexColor("#B71C1C")   # red        – complications
C_GREEN   = HexColor("#2E7D32")   # green      – treatment
C_PURPLE  = HexColor("#4A148C")   # purple     – nursing
C_GREY    = HexColor("#F5F5F5")   # light grey – row alternation
C_WHITE   = colors.white
C_BLACK   = colors.black

PAGE_W, PAGE_H = A4
MARGIN = 15 * mm

# ── Document ─────────────────────────────────────────────────────────────────
doc = SimpleDocTemplate(
    "/tmp/workspace/endocrine-cheatsheet/Endocrine_Disorders_Cheatsheet.pdf",
    pagesize=A4,
    leftMargin=MARGIN, rightMargin=MARGIN,
    topMargin=12*mm, bottomMargin=12*mm,
    title="Endocrine Disorders – Nursing Cheat Sheet",
    author="Orris Medical"
)

styles = getSampleStyleSheet()

# Custom styles
def S(name, **kw):
    base = kw.pop("parent", "Normal")
    s = ParagraphStyle(name, parent=styles[base], **kw)
    return s

sTitle    = S("sTitle",    fontSize=20, textColor=C_WHITE,   alignment=TA_CENTER,
               fontName="Helvetica-Bold", spaceAfter=2)
sSubTitle = S("sSubTitle", fontSize=10, textColor=HexColor("#B3E5FC"), alignment=TA_CENTER,
               fontName="Helvetica", spaceAfter=0)
sDisHead  = S("sDisHead",  fontSize=12, textColor=C_WHITE,   alignment=TA_LEFT,
               fontName="Helvetica-Bold", leftIndent=4)
sDef      = S("sDef",      fontSize=8,  textColor=C_NAVY,    fontName="Helvetica-BoldOblique",
               spaceAfter=2, spaceBefore=1)
sLabel    = S("sLabel",    fontSize=7.5,textColor=C_WHITE,   fontName="Helvetica-Bold",
               leftIndent=2)
sBody     = S("sBody",     fontSize=7.5,textColor=C_BLACK,   fontName="Helvetica",
               spaceAfter=1, spaceBefore=0, leading=10)
sBullet   = S("sBullet",   fontSize=7.5,textColor=C_BLACK,   fontName="Helvetica",
               spaceAfter=0, spaceBefore=0, leftIndent=8, leading=10,
               bulletIndent=2)
sFooter   = S("sFooter",   fontSize=6.5,textColor=colors.grey, alignment=TA_CENTER)
sTableHdr = S("sTableHdr", fontSize=7,  textColor=C_WHITE,   fontName="Helvetica-Bold",
               alignment=TA_CENTER, leading=9)
sTableCell= S("sTableCell",fontSize=6.5,textColor=C_BLACK,   fontName="Helvetica",
               alignment=TA_CENTER, leading=8)

# ── Helper builders ───────────────────────────────────────────────────────────
def bullet_para(items, color=C_BLACK):
    """Return a list of bullet Paragraphs."""
    out = []
    for item in items:
        p = Paragraph(f"• {item}", sBullet)
        out.append(p)
    return out

def section_label(text, bg_color):
    """Coloured inline label row."""
    tbl = Table([[Paragraph(text, sLabel)]], colWidths=["100%"])
    tbl.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), bg_color),
        ("TOPPADDING",  (0,0), (-1,-1), 1),
        ("BOTTOMPADDING",(0,0),(-1,-1), 1),
        ("LEFTPADDING", (0,0), (-1,-1), 4),
    ]))
    return tbl

def disorder_block(num, name, color, definition,
                   patho, risks, signs, complications,
                   pattern, management, nd, nursing):
    """Build one disorder card as a list of Flowables."""
    W = PAGE_W - 2*MARGIN
    elems = []

    # ── Disorder header bar ──────────────────────────────────
    hdr_tbl = Table(
        [[Paragraph(f"{num}. {name}", sDisHead)]],
        colWidths=[W]
    )
    hdr_tbl.setStyle(TableStyle([
        ("BACKGROUND",    (0,0),(-1,-1), color),
        ("TOPPADDING",    (0,0),(-1,-1), 5),
        ("BOTTOMPADDING", (0,0),(-1,-1), 5),
        ("LEFTPADDING",   (0,0),(-1,-1), 8),
        ("ROUNDEDCORNERS",[4,4,0,0]),
    ]))
    elems.append(hdr_tbl)

    # ── Definition row ──────────────────────────────────────
    def_tbl = Table([[Paragraph(definition, sDef)]], colWidths=[W])
    def_tbl.setStyle(TableStyle([
        ("BACKGROUND",    (0,0),(-1,-1), C_LTBLUE),
        ("TOPPADDING",    (0,0),(-1,-1), 3),
        ("BOTTOMPADDING", (0,0),(-1,-1), 3),
        ("LEFTPADDING",   (0,0),(-1,-1), 8),
    ]))
    elems.append(def_tbl)

    # ── 2-column body ────────────────────────────────────────
    col1 = []
    col2 = []

    # Left column: Pathophysiology + Risk Factors + Signs & Symptoms
    col1.append(section_label("⚙ PATHOPHYSIOLOGY", C_TEAL))
    col1 += bullet_para(patho)
    col1.append(Spacer(1, 3))
    col1.append(section_label("⚠ RISK FACTORS", C_AMBER))
    col1 += bullet_para(risks)
    col1.append(Spacer(1, 3))
    col1.append(section_label("🩺 SIGNS & SYMPTOMS", C_BLUE))
    col1 += bullet_para(signs)

    # Right column: Complications + Pattern + Management + Nursing
    col2.append(section_label("❗ COMPLICATIONS", C_RED))
    col2 += bullet_para(complications)
    col2.append(Spacer(1, 3))
    col2.append(section_label("📊 DISEASE PATTERN", HexColor("#5D4037")))
    col2 += bullet_para(pattern)
    col2.append(Spacer(1, 3))
    col2.append(section_label("💊 MEDICAL MANAGEMENT", C_GREEN))
    col2 += bullet_para(management)
    col2.append(Spacer(1, 3))
    col2.append(section_label("🏥 NURSING DX & INTERVENTIONS", C_PURPLE))
    for i, (dx, interv) in enumerate(zip(nd, nursing), 1):
        col2.append(Paragraph(f"<b>{i}. {dx}</b>", sBody))
        col2 += bullet_para(interv)

    # Pack into 2-col table
    body = Table(
        [[col1, col2]],
        colWidths=[W*0.48, W*0.48],
        spaceBefore=0
    )
    body.setStyle(TableStyle([
        ("VALIGN",        (0,0),(-1,-1), "TOP"),
        ("LEFTPADDING",   (0,0),(-1,-1), 4),
        ("RIGHTPADDING",  (0,0),(-1,-1), 4),
        ("TOPPADDING",    (0,0),(-1,-1), 4),
        ("BOTTOMPADDING", (0,0),(-1,-1), 4),
        ("BACKGROUND",    (0,0),(-1,-1), C_WHITE),
        ("BOX",           (0,0),(-1,-1), 0.5, colors.lightgrey),
        ("LINEBEFORE",    (1,0),(1,-1),  0.5, colors.lightgrey),
    ]))
    elems.append(body)
    elems.append(Spacer(1, 6))
    return elems

# ═══════════════════════════════════════════════════════════════════════════
# DATA
# ═══════════════════════════════════════════════════════════════════════════

disorders = [
    # 1 ── TYPE 1 DM
    dict(
        num=1, name="TYPE 1 DIABETES MELLITUS", color=HexColor("#0D47A1"),
        definition="Autoimmune destruction of pancreatic beta cells → absolute insulin deficiency → chronic hyperglycemia.",
        patho=[
            "Autoimmune trigger (virus/environment)",
            "T-cells attack beta cells in pancreas",
            "Beta cells destroyed → zero insulin production",
            "Glucose cannot enter cells → hyperglycemia",
            "Body burns fat → ketone bodies produced",
            "Ketoacidosis (DKA) if untreated",
        ],
        risks=["Family history of T1DM","Autoimmune conditions (e.g. Hashimoto's)","Viral infections (Coxsackievirus)","HLA-DR3/DR4 genotype"],
        signs=["Polydipsia, Polyuria, Polyphagia (3 Polys)","Sudden unexplained weight loss","Fatigue, blurred vision","Fruity breath (DKA)","Nausea/vomiting"],
        complications=["DKA (acute emergency)","Hypoglycemia (insulin excess)","Retinopathy → blindness","Nephropathy → renal failure","Neuropathy, CVD, gangrene"],
        pattern=["Young onset, sudden presentation","Lean body habitus","Requires lifelong insulin","Brittle glucose control"],
        management=["Basal-bolus insulin regimen","Continuous glucose monitoring","Carbohydrate counting","HbA1c target <7%","Annual eye/foot/kidney review"],
        nd=["Risk for Unstable Blood Glucose","Deficient Knowledge","Risk for Infection"],
        nursing=[
            ["Monitor BGL QID (before meals + bedtime)","Check urine/blood ketones if BGL >14","Assess injection sites"],
            ["Teach insulin injection technique","Teach hypoglycemia recognition & treatment","Sick-day rules education"],
            ["Inspect feet daily; no barefoot","Promote hand hygiene","Monitor for wound healing"],
        ]
    ),
    # 2 ── TYPE 2 DM
    dict(
        num=2, name="TYPE 2 DIABETES MELLITUS", color=HexColor("#1565C0"),
        definition="Insulin resistance + progressive beta-cell dysfunction → relative insulin deficiency → chronic hyperglycemia.",
        patho=[
            "Obesity/inactivity → insulin resistance develops",
            "Pancreas compensates by secreting more insulin",
            "Over years, beta cells 'burn out'",
            "Insulin secretion drops + resistance remains",
            "Chronic hyperglycemia damages blood vessels & nerves",
        ],
        risks=["BMI >25 / Obesity","Sedentary lifestyle","Age >45","Family history of T2DM","Hypertension, dyslipidaemia","Gestational DM / PCOS"],
        signs=["Often asymptomatic early","3 Polys (milder than T1)","Fatigue, slow-healing wounds","Recurrent UTI/skin infections","Numbness/tingling in feet"],
        complications=["Hyperosmolar hyperglycaemic state (HHS)","Macrovascular: MI, stroke, PAD","Microvascular: retinopathy, nephropathy, neuropathy","Foot ulcers / gangrene"],
        pattern=["Gradual onset over years","Usually in adults (now also youth)","Progressive; often needs insulin eventually","Associated with metabolic syndrome"],
        management=["Lifestyle: diet + exercise (1st line)","Metformin (1st-line drug)","SGLT-2 inhibitors, GLP-1 agonists","Sulfonylureas, DPP-4 inhibitors","Insulin if inadequate control","BP <130/80, statins, annual screening"],
        nd=["Imbalanced Nutrition: More than body requirements","Risk for Unstable Blood Glucose","Deficient Knowledge"],
        nursing=[
            ["Teach portion control & low-GI diet","Encourage 150 min/week moderate exercise","Monitor weight weekly"],
            ["Check fasting & post-meal BGL","Administer medications as prescribed","Monitor HbA1c every 3 months"],
            ["Diabetes self-management education","Foot care: inspect daily, trim nails properly","Ophthalmology referral annually"],
        ]
    ),
    # 3 ── HYPERTHYROIDISM
    dict(
        num=3, name="HYPERTHYROIDISM (Graves' Disease)", color=HexColor("#006064"),
        definition="Excess thyroid hormone (T3/T4) production → hypermetabolic state. Graves' disease (autoimmune) is the most common cause (~85%).",
        patho=[
            "Immune system produces TSI antibodies",
            "TSI binds TSH receptors → continuous thyroid stimulation",
            "Excess T3/T4 released into circulation",
            "Increased basal metabolic rate throughout body",
            "Increased O2 consumption, heat production",
            "Enhanced catecholamine sensitivity → tachycardia/tremor",
        ],
        risks=["Female sex (5–10x more common)","Age 20–40 years","Family history of thyroid/autoimmune disease","Smoking (Graves' ophthalmopathy)","Pregnancy, iodine excess, stress"],
        signs=["Heat intolerance, sweating","Weight loss despite increased appetite","Palpitations, tachycardia, AF","Hand tremor, anxiety, irritability","Diarrhoea, frequent stools","Exophthalmos (bulging eyes)","Goitre, smooth warm skin"],
        complications=["Thyroid storm (fever >40°C, extreme tachy, confusion)","Atrial fibrillation → stroke","Osteoporosis (long-term)","Heart failure","Graves' ophthalmopathy → blindness"],
        pattern=["Chronic autoimmune; flares and remissions","Symptoms build over weeks-months","May relapse after treatment"],
        management=["Methimazole / PTU (antithyroid drugs)","Propranolol (beta-blocker for symptom control)","Radioactive iodine (RAI) – definitive","Thyroidectomy for large goitre","Lifelong levothyroxine after RAI/surgery"],
        nd=["Decreased Cardiac Output","Imbalanced Nutrition: Less than body requirements","Activity Intolerance"],
        nursing=[
            ["Monitor HR, rhythm, BP frequently","Report HR >100 or irregular rhythm","Administer beta-blockers as prescribed"],
            ["Provide high-calorie, high-protein diet","Frequent small meals","Weigh daily – gain = treatment response"],
            ["Cool, quiet environment","Limit visitors; promote rest","Graduated activity as tolerated"],
        ]
    ),
    # 4 ── HYPOTHYROIDISM
    dict(
        num=4, name="HYPOTHYROIDISM (Hashimoto's)", color=HexColor("#004D40"),
        definition="Insufficient thyroid hormone (T3/T4) production → reduced metabolic rate. Hashimoto's thyroiditis (autoimmune) is the most common cause.",
        patho=[
            "Autoimmune T-cell attack on thyroid gland",
            "Lymphocytic infiltration → follicle destruction",
            "Thyroid follicles become atrophic, replaced by fibrosis",
            "T3/T4 production falls progressively",
            "Pituitary senses low T4 → TSH rises (compensatory)",
            "Thyroid cannot respond → hypothyroid state",
        ],
        risks=["Female sex","Age >50","Autoimmune diseases (T1DM, RA, lupus)","Previous thyroid surgery / RAI","Iodine deficiency (global)","Lithium or amiodarone use"],
        signs=["Cold intolerance","Weight gain despite poor appetite","Fatigue, lethargy, sluggishness","Bradycardia","Constipation","Dry skin, brittle hair, hair loss","Puffy face (myxoedema)","Depression, brain fog","Hoarse voice, heavy periods"],
        complications=["Myxoedema coma (life-threatening)","Hyperlipidaemia → CVD","Pericardial effusion","Infertility & pregnancy complications","Peripheral neuropathy","Goitre"],
        pattern=["Slow insidious onset (months-years)","Lifelong condition","Regular monitoring every 6–12 months"],
        management=["Levothyroxine (T4) – drug of choice","Once daily, on empty stomach","Start low, titrate to TSH target 0.5–2.5 mIU/L","Myxoedema coma: IV T3/T4 + steroids + ICU"],
        nd=["Activity Intolerance","Constipation","Disturbed Body Image"],
        nursing=[
            ["Monitor energy level, HR, temperature","Administer levothyroxine as prescribed","Teach: empty stomach, wait 30–60 min before eating"],
            ["High-fibre diet & adequate fluid intake","Encourage gentle ambulation","Assess bowel sounds & patterns"],
            ["Acknowledge feelings about physical changes","Reassure that symptoms improve with treatment","Support group referral if needed"],
        ]
    ),
    # 5 ── CUSHING'S
    dict(
        num=5, name="CUSHING'S SYNDROME", color=HexColor("#4A148C"),
        definition="Prolonged exposure to excess cortisol – from pituitary adenoma (ACTH excess), adrenal adenoma, or long-term exogenous steroid use.",
        patho=[
            "Pituitary adenoma → excess ACTH released",
            "ACTH stimulates adrenal cortex → excess cortisol",
            "Cortisol breaks down protein & redistributes fat",
            "Fat deposits: face (moon face), trunk, upper back (buffalo hump)",
            "Cortisol raises blood glucose → secondary diabetes",
            "Cortisol suppresses immunity → infections",
            "Cortisol weakens bones → osteoporosis",
        ],
        risks=["Long-term steroid medication (most common cause)","Pituitary adenoma","Adrenal adenoma/carcinoma","Ectopic ACTH (small cell lung cancer)","Female sex"],
        signs=["Moon face + Buffalo hump + Central obesity (classic triad)","Purple/violet striae on abdomen","Thin skin, easy bruising","Proximal muscle weakness","Hypertension, hyperglycaemia","Hirsutism in women","Poor wound healing","Mood changes, depression, psychosis"],
        complications=["Type 2 diabetes","Severe opportunistic infections","Osteoporotic fractures","Cardiovascular disease","Adrenal crisis if steroids stopped abruptly","Psychiatric disorders"],
        pattern=["Gradual onset over months-years","Diagnosis often delayed (symptoms attributed elsewhere)","Exogenous type: reversible with steroid taper"],
        management=["Transsphenoidal surgery (pituitary adenoma – 1st line)","Adrenalectomy (adrenal adenoma)","Slow steroid taper (exogenous)","Metyrapone/ketoconazole (cortisol blockers)","Antihypertensives, diabetes Rx, bisphosphonates"],
        nd=["Risk for Infection","Risk for Injury","Disturbed Body Image"],
        nursing=[
            ["Strict infection control (hand hygiene)","Avoid contact with infected individuals","Monitor for fever, wound changes"],
            ["Fall prevention: non-slip footwear, bed rails","Gentle skin handling; avoid tape on skin","Assess for fractures after minimal trauma"],
            ["Emotional support; normalise feelings","Educate that physical changes improve post-treatment","Encourage expression of concerns"],
        ]
    ),
    # 6 ── ADDISON'S
    dict(
        num=6, name="ADDISON'S DISEASE", color=HexColor("#B71C1C"),
        definition="Primary adrenal insufficiency: adrenal cortex cannot produce enough cortisol ± aldosterone. Life-threatening adrenal crisis can occur with stress.",
        patho=[
            "Autoimmune attack OR TB/infection destroys adrenal cortex",
            "Cortisol production falls → cannot handle physiological stress",
            "Aldosterone falls → Na⁺ wasted in urine, K⁺ retained",
            "Low Na⁺ → hyponatraemia, hypotension, dehydration",
            "High K⁺ → hyperkalaemia → cardiac risk",
            "Low cortisol → ACTH rises (loss of feedback)",
            "High ACTH stimulates melanocytes → bronze skin (hallmark)",
        ],
        risks=["Autoimmune disease (developed world – most common)","Tuberculosis (global most common)","HIV/AIDS, fungal infections","Adrenal metastases (lung, breast CA)","Bilateral adrenalectomy","Abrupt steroid withdrawal"],
        signs=["Bronze/hyperpigmented skin (gums, knuckles, skin folds)","Fatigue, profound weakness, weight loss","Anorexia, nausea, vomiting, abdo pain","Postural hypotension, dizziness","Salt craving","Hypoglycaemia","Hyponatraemia, hyperkalaemia"],
        complications=["Adrenal/Addisonian crisis (shock, confusion, collapse)","Severe hyponatraemia → seizures","Hyperkalaemic arrhythmias","Death if untreated crisis"],
        pattern=["Chronic, lifelong","Slowly progressive","Crises triggered by illness, surgery, trauma, stress"],
        management=["Hydrocortisone 15–25 mg/day (larger AM dose)","Fludrocortisone (mineralocorticoid replacement)","Adrenal crisis: IV hydrocortisone 100 mg stat + IV NS + dextrose","Sick day rules: double/triple dose during illness","Medical alert bracelet – MANDATORY"],
        nd=["Deficient Fluid Volume","Fatigue","Risk for Ineffective Coping"],
        nursing=[
            ["Monitor BP (especially orthostatic)","IV access ready; prepare normal saline","Strict I&O; daily weight"],
            ["Plan care with frequent rest periods","Assist with ADLs as needed","Encourage gradual activity increase"],
            ["Educate: never miss doses; always carry emergency kit","Teach injection of emergency hydrocortisone","Connect to support groups"],
        ]
    ),
    # 7 ── ACROMEGALY
    dict(
        num=7, name="ACROMEGALY", color=HexColor("#1B5E20"),
        definition="Excess growth hormone (GH) in adults (after growth plates close) from a pituitary adenoma → abnormal enlargement of bones and organs.",
        patho=[
            "Pituitary adenoma secretes excess GH",
            "GH stimulates liver → excess IGF-1 production",
            "IGF-1 promotes periosteal bone growth, soft tissue growth",
            "Bones of face, hands, feet grow abnormally",
            "Organs enlarge (tongue, heart, liver, kidneys)",
            "GH causes insulin resistance → secondary diabetes",
            "Growing tumour may compress optic chiasm → visual loss",
        ],
        risks=["Pituitary adenoma (>99% of cases)","MEN1 syndrome","Ectopic GHRH-secreting tumours (rare)"],
        signs=["Large hands & feet (rings/shoes no longer fit)","Coarse facial features: prominent jaw, large nose/lips","Widely spaced teeth, malocclusion","Headaches (from tumour)","Bitemporal hemianopia (visual field defect)","Excessive sweating, oily skin","Joint pain, carpal tunnel syndrome","Husky voice, sleep apnoea"],
        complications=["Cardiomyopathy / heart failure (leading cause of death)","Type 2 diabetes","Hypertension","Colorectal cancer (colon polyps)","Blindness (optic nerve compression)","Pituitary insufficiency"],
        pattern=["Very slow onset; avg 8–10 years to diagnosis","Subtle facial changes often missed","Serial photos show progression"],
        management=["Transsphenoidal surgery (1st line)","Somatostatin analogues: Octreotide, Lanreotide","GH receptor antagonist: Pegvisomant","Dopamine agonists: Cabergoline","Radiotherapy if surgery fails","Monitor IGF-1 levels"],
        nd=["Disturbed Body Image","Acute Pain","Impaired Physical Mobility"],
        nursing=[
            ["Post-op: monitor for CSF leak, DI, visual changes","Acknowledge distress about appearance","Educate that features improve with treatment"],
            ["Administer analgesics for headache & joint pain","Joint protection strategies","Carpal tunnel splinting"],
            ["Proper footwear for enlarged feet","Encourage range-of-motion exercises","Refer to physiotherapy"],
        ]
    ),
    # 8 ── DIABETES INSIPIDUS
    dict(
        num=8, name="DIABETES INSIPIDUS (DI)", color=HexColor("#E65100"),
        definition="ADH (vasopressin) deficiency (Central DI) or renal resistance to ADH (Nephrogenic DI) → inability to concentrate urine → massive water loss.",
        patho=[
            "Central: hypothalamus/pituitary damaged → no ADH released",
            "Nephrogenic: ADH present but kidneys cannot respond",
            "Without ADH: collecting duct impermeable to water",
            "Water stays in tubule → excreted as dilute urine",
            "Massive diuresis: 3–20 litres/day",
            "Blood becomes concentrated (high serum osmolality)",
            "Intense thirst triggered (polydipsia) to compensate",
        ],
        risks=["Head trauma / neurosurgery","Pituitary / hypothalamic tumour","Meningitis, encephalitis","Lithium use (Nephrogenic)","Hypercalcaemia, hypokalaemia","Genetic mutations (rare)"],
        signs=["Extreme polyuria: 3–20 L/day, pale/colourless urine","Extreme polydipsia (craving cold water)","Nocturia","Dehydration if fluid not replaced","Fatigue, dizziness","Hypernatraemia signs: confusion, seizures"],
        complications=["Severe dehydration","Hypernatraemia → seizures, coma, brain damage","Bladder distension","Death if access to water restricted"],
        pattern=["Often sudden onset (post-trauma/surgery)","Lifelong in most cases","Central DI may recover if cause treated"],
        management=["Central DI: Desmopressin (DDAVP) – intranasal/oral/IV","Nephrogenic: Treat cause (stop lithium, correct Ca/K)","Nephrogenic: Thiazide diuretics (paradoxical effect)","Low-salt, low-protein diet (Nephrogenic)","Adequate fluid replacement always"],
        nd=["Deficient Fluid Volume","Risk for Electrolyte Imbalance (Hypernatraemia)","Disturbed Sleep Pattern (Nocturia)"],
        nursing=[
            ["Strict hourly I&O; daily weight","Monitor serum Na & osmolality","Ensure free water access at all times"],
            ["Monitor for confusion, seizures (hypernatraemia)","Administer DDAVP as prescribed","Do not over-restrict fluid"],
            ["Hourly urine output monitoring post-neurosurgery","Cluster care to allow undisturbed sleep","Bedside commode / urinal for nocturia safety"],
        ]
    ),
    # 9 ── SIADH
    dict(
        num=9, name="SIADH", color=HexColor("#880E4F"),
        definition="Syndrome of Inappropriate ADH Secretion: excess ADH causes kidneys to retain too much water → dilutional hyponatraemia.",
        patho=[
            "ADH secreted despite low serum osmolality (inappropriate)",
            "Causes: CNS disease, lung disease, small cell lung CA, drugs",
            "Kidneys retain excess free water",
            "Blood volume increases → diluted blood",
            "Serum sodium falls → hyponatraemia",
            "Brain cells absorb water → cerebral oedema",
            "Neurological symptoms proportional to severity",
        ],
        risks=["CNS: meningitis, stroke, head injury, brain tumour","Pulmonary: pneumonia, TB, small cell lung cancer","Drugs: SSRIs, carbamazepine, NSAIDs, morphine, vincristine","Post-operative (especially thoracic/abdominal)"],
        signs=["Mild: nausea, headache, fatigue, weakness","Moderate: confusion, lethargy, muscle cramps","Severe: seizures, coma","Low urine output despite normal fluid intake","Weight gain without visible oedema"],
        complications=["Seizures and coma (severe hyponatraemia)","Central pontine myelinolysis (too-rapid correction) – permanent brain damage","Cerebral herniation → death"],
        pattern=["Acute or chronic depending on cause","Resolves when underlying cause treated","Chronic SIADH if malignancy persists"],
        management=["Fluid restriction 800–1000 mL/day (cornerstone)","Severe symptomatic (Na <120): 3% hypertonic saline slowly","Max correction: 8–10 mEq/L in 24 hours","Vaptans: Tolvaptan, Conivaptan (V2-receptor antagonists)","Treat underlying cause"],
        nd=["Excess Fluid Volume","Risk for Injury (altered mental status)","Deficient Knowledge (fluid restriction)"],
        nursing=[
            ["Strict fluid restriction; measure all intake","Daily weight; strict I&O","Monitor serum Na every 4–6 hours"],
            ["Seizure precautions: raised rails, O2 available, padded","Neurological checks (GCS, orientation)","Fall risk assessment; assist with mobilisation"],
            ["Explain why fluid is restricted","Use small cups to limit intake","Oral care for thirst relief without fluid load"],
        ]
    ),
    # 10 ── PHAEOCHROMOCYTOMA
    dict(
        num=10, name="PHAEOCHROMOCYTOMA", color=HexColor("#37474F"),
        definition="Rare catecholamine-secreting tumour of adrenal medulla → episodic massive release of epinephrine/norepinephrine → hypertensive crises.",
        patho=[
            "Chromaffin cell tumour in adrenal medulla",
            "Tumour releases catecholamines in bursts (or continuously)",
            "Alpha-receptor stimulation → intense vasoconstriction → BP spike",
            "Beta-receptor stimulation → tachycardia, increased cardiac output",
            "Hepatic glycogenolysis → hyperglycaemia",
            "Episodes triggered by exercise, stress, abdominal pressure, certain foods",
        ],
        risks=["MEN2 syndrome","Von Hippel-Lindau (VHL) disease","Neurofibromatosis type 1 (NF1)","Family history","Age 40–60 (but any age)"],
        signs=["Classic 5 Ps:","Pressure (severe paroxysmal hypertension – hallmark)","Pounding headache","Palpitations (tachycardia)","Perspiration (profuse)","Pallor (during attacks)","Also: anxiety/panic, tremor, weight loss, chest pain"],
        complications=["Hypertensive crisis → stroke, MI, aortic dissection","Catecholamine cardiomyopathy","Death during surgery if unprepared (catecholamine surge)","10% malignant → metastases"],
        pattern=["Paroxysmal attacks (minutes to hours)","Can be triggered or spontaneous","Rule of 10s: 10% bilateral, 10% extra-adrenal, 10% malignant, 10% in children"],
        management=["Alpha-blocker FIRST (phenoxybenzamine/doxazosin) × 2 weeks","THEN beta-blocker (propranolol) – NEVER beta before alpha","High-Na diet + hydration (expand blood volume pre-op)","Adrenalectomy (curative)","Malignant: MIBG therapy, chemotherapy"],
        nd=["Risk for Ineffective Tissue Perfusion","Anxiety","Deficient Knowledge (triggers, pre-op prep)"],
        nursing=[
            ["Continuous BP & cardiac monitoring","Avoid abdominal palpation (can trigger crisis)","Administer alpha-blockers; NEVER give beta-blocker alone"],
            ["Calm environment; minimise stressors","Explain all procedures before performing","Anxiolytic medication as prescribed"],
            ["Teach to avoid tyramine foods (aged cheese, red wine)","Avoid straining / constipation","Post-op: watch for hypotension (sudden catecholamine drop)"],
        ]
    ),
]

# ── Build quick-reference comparison table ───────────────────────────────────
def build_summary_table():
    W = PAGE_W - 2*MARGIN
    header = ["#", "Disorder", "Core Problem", "Key Hormone", "Classic Sign", "Key Drug/Treatment"]
    rows = [header]
    data = [
        ["1","Type 1 DM","No insulin","↓ Insulin","DKA, polyuria","Insulin"],
        ["2","Type 2 DM","Insulin resistance","Relative ↓ Insulin","Obesity, gradual","Metformin"],
        ["3","Hyperthyroidism","Excess T3/T4","↑ T3/T4","Exophthalmos","Methimazole / RAI"],
        ["4","Hypothyroidism","Low T3/T4","↓ T3/T4","Cold intolerance, weight gain","Levothyroxine"],
        ["5","Cushing's","Excess cortisol","↑ Cortisol","Moon face, buffalo hump","Surgery / steroid taper"],
        ["6","Addison's","Low cortisol/aldosterone","↓ Cortisol","Bronze skin, hypotension","Hydrocortisone + Fludrocortisone"],
        ["7","Acromegaly","Excess GH","↑ GH / IGF-1","Large hands/feet","Transsphenoidal surgery"],
        ["8","Diabetes Insipidus","No ADH effect","↓ ADH (or resistance)","Massive dilute urine","Desmopressin (DDAVP)"],
        ["9","SIADH","Excess ADH","↑ ADH","Hyponatraemia, confusion","Fluid restriction / Vaptans"],
        ["10","Hyperparathyroidism","Excess PTH","↑ PTH","Stones, Bones, Groans","Parathyroidectomy"],
        ["11","Phaeochromocytoma","Catecholamine excess","↑ Epinephrine/NE","Paroxysmal hypertension","Alpha-block then surgery"],
    ]
    rows += rows  # placeholder, overwrite
    rows = [header] + data

    col_ws = [W*0.04, W*0.15, W*0.17, W*0.14, W*0.22, W*0.28]
    tbl = Table(rows, colWidths=col_ws, repeatRows=1)
    style = [
        ("BACKGROUND",    (0,0),(-1,0), C_NAVY),
        ("TEXTCOLOR",     (0,0),(-1,0), C_WHITE),
        ("FONTNAME",      (0,0),(-1,0), "Helvetica-Bold"),
        ("FONTSIZE",      (0,0),(-1,-1), 7),
        ("ALIGN",         (0,0),(-1,-1), "CENTER"),
        ("VALIGN",        (0,0),(-1,-1), "MIDDLE"),
        ("GRID",          (0,0),(-1,-1), 0.3, colors.grey),
        ("ROWBACKGROUNDS",(0,1),(-1,-1), [C_WHITE, C_GREY]),
        ("TOPPADDING",    (0,0),(-1,-1), 3),
        ("BOTTOMPADDING", (0,0),(-1,-1), 3),
    ]
    tbl.setStyle(TableStyle(style))

    # Wrap cells
    for r_idx, row in enumerate(rows):
        for c_idx, cell in enumerate(row):
            rows[r_idx][c_idx] = Paragraph(str(cell), sTableHdr if r_idx==0 else sTableCell)

    tbl2 = Table(rows, colWidths=col_ws, repeatRows=1)
    tbl2.setStyle(TableStyle(style))
    return tbl2

# ── Title page banner ─────────────────────────────────────────────────────────
def title_banner():
    W = PAGE_W - 2*MARGIN
    elems = []
    banner = Table(
        [[Paragraph("ENDOCRINE DISORDERS", sTitle)],
         [Paragraph("Complete Nursing Cheat Sheet  |  Definition · Pathophysiology · Risk Factors · Signs & Symptoms · Complications · Disease Pattern · Medical Management · Nursing Diagnosis & Interventions", sSubTitle)]],
        colWidths=[W]
    )
    banner.setStyle(TableStyle([
        ("BACKGROUND",    (0,0),(-1,-1), C_NAVY),
        ("TOPPADDING",    (0,0),(-1,-1), 8),
        ("BOTTOMPADDING", (0,0),(-1,-1), 8),
        ("LEFTPADDING",   (0,0),(-1,-1), 10),
        ("ROUNDEDCORNERS",[6,6,6,6]),
    ]))
    elems.append(banner)
    elems.append(Spacer(1, 6))

    # Quick-reference summary table
    elems.append(Paragraph("<b>QUICK REFERENCE SUMMARY</b>", S("qr", fontSize=9, fontName="Helvetica-Bold", textColor=C_NAVY)))
    elems.append(Spacer(1, 3))
    elems.append(build_summary_table())
    elems.append(Spacer(1, 6))
    return elems

# ── Assemble document ─────────────────────────────────────────────────────────
story = []
story += title_banner()

for d in disorders:
    story += disorder_block(**d)

# Footer note
story.append(HRFlowable(width="100%", thickness=0.5, color=colors.lightgrey))
story.append(Spacer(1, 3))
story.append(Paragraph(
    "Sources: Robbins &amp; Kumar Basic Pathology | Goldman-Cecil Medicine | Textbook of Family Medicine 9e | Sabiston Textbook of Surgery  •  Generated by Orris Medical AI",
    sFooter
))

doc.build(story)
print("PDF generated successfully!")