const pptxgen = require("pptxgenjs");
const pres = new pptxgen();
pres.layout = "LAYOUT_WIDE"; // 13.3" x 7.5"
pres.title = "FMGE 30-Month Subject-Wise Study Timeline";
pres.author = "Orris";

// ─── Color palette ────────────────────────────────────────────────────────────
const C = {
  navy:    "0D1B2A",  // dominant dark bg
  teal:    "1B998B",  // accent / highlights
  gold:    "FFBF00",  // warm accent
  slate:   "2E4057",  // secondary panels
  white:   "FFFFFF",
  lightBg: "F0F4F8",  // light slide bg
  muted:   "8899AA",
  green:   "2DC653",
  orange:  "F4721E",
  red:     "E63946",
  purple:  "7B2D8B",
  pink:    "D7263D",
  sky:     "118AB2",
  lime:    "80B918",
};

// ─── Phase colors ────────────────────────────────────────────────────────────
const PHASE_COLORS = {
  1: "1B998B",  // teal
  2: "118AB2",  // sky
  3: "7B2D8B",  // purple
  4: "F4721E",  // orange
  5: "2DC653",  // green
};

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 1 – COVER
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();

  // Full dark background
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.navy } });

  // Teal accent bar left
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.18, h: 7.5, fill: { color: C.teal } });

  // Gold accent strip top
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 0.06, fill: { color: C.gold } });

  // Background decorative circle
  s.addShape(pres.ShapeType.ellipse, { x: 8.5, y: 3.5, w: 6, h: 6,
    fill: { color: "1B3A5C", transparency: 60 }, line: { color: C.teal, width: 1, transparency: 70 } });

  s.addText("FMGE", {
    x: 0.5, y: 1.0, w: 10, h: 1.6,
    fontSize: 80, bold: true, color: C.white,
    fontFace: "Calibri", charSpacing: 12, margin: 0
  });

  s.addText("30-Month Subject-Wise Study Timeline", {
    x: 0.5, y: 2.7, w: 10, h: 0.75,
    fontSize: 26, bold: false, color: C.teal, fontFace: "Calibri", margin: 0
  });

  // Divider line
  s.addShape(pres.ShapeType.rect, { x: 0.5, y: 3.55, w: 5.5, h: 0.05, fill: { color: C.gold } });

  s.addText("Starting July 2026  →  December 2028", {
    x: 0.5, y: 3.75, w: 9, h: 0.5,
    fontSize: 18, color: C.muted, fontFace: "Calibri", margin: 0
  });

  s.addText("5 Phases  |  19 Subjects  |  2–3 Exam Attempts  |  Pass Mark: 150/300", {
    x: 0.5, y: 4.35, w: 10, h: 0.45,
    fontSize: 14, color: "7AADCC", fontFace: "Calibri", margin: 0
  });

  // Tag pills
  const tags = ["No Negative Marking", "CBT Mode", "Twice a Year", "300 MCQs"];
  tags.forEach((t, i) => {
    const tx = 0.5 + i * 2.8;
    s.addShape(pres.ShapeType.roundRect, { x: tx, y: 5.2, w: 2.5, h: 0.42,
      fill: { color: C.slate }, line: { color: C.teal, width: 1 }, rectRadius: 0.12 });
    s.addText(t, { x: tx, y: 5.2, w: 2.5, h: 0.42,
      fontSize: 11, color: C.teal, align: "center", valign: "middle", margin: 0 });
  });

  s.addText("Orris AI  |  June 2026", {
    x: 0.5, y: 6.8, w: 5, h: 0.35,
    fontSize: 10, color: C.muted, fontFace: "Calibri", margin: 0
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 2 – 30-MONTH PHASE OVERVIEW (horizontal timeline bar)
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.lightBg } });
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 0.85, fill: { color: C.navy } });
  s.addText("30-Month Phase Overview", {
    x: 0.4, y: 0.12, w: 12, h: 0.6,
    fontSize: 24, bold: true, color: C.white, margin: 0
  });
  s.addText("July 2026 – December 2028", {
    x: 9.5, y: 0.18, w: 3.4, h: 0.5,
    fontSize: 12, color: C.teal, align: "right", margin: 0
  });

  // Phase data: [label, months, dateRange, color, desc]
  const phases = [
    ["Phase 1", "Months 1–8", "Jul 2026 – Feb 2027", PHASE_COLORS[1], "Pre-clinical + Para-clinical Foundation"],
    ["Phase 2", "Months 9–14", "Mar 2027 – Aug 2027", PHASE_COLORS[2], "Clinical Subjects + Integration"],
    ["Phase 3", "Months 15–18", "Sep 2027 – Dec 2027", PHASE_COLORS[3], "1st Attempt Sprint (Dec 2027)"],
    ["Phase 4", "Months 19–24", "Jan 2028 – Jun 2028", PHASE_COLORS[4], "Review + 2nd Attempt (Jun 2028)"],
    ["Phase 5", "Months 25–30", "Jul 2028 – Dec 2028", PHASE_COLORS[5], "Buffer + 3rd Attempt (Dec 2028)"],
  ];

  // Timeline bar
  const barY = 1.5, barH = 0.55, barStartX = 0.4, totalW = 12.5;
  // Widths proportional to month counts: 8, 6, 4, 6, 6 = 30
  const monthCounts = [8, 6, 4, 6, 6];
  const total = 30;
  let curX = barStartX;
  monthCounts.forEach((mc, i) => {
    const w = (mc / total) * totalW;
    s.addShape(pres.ShapeType.rect, { x: curX, y: barY, w: w, h: barH,
      fill: { color: phases[i][3] }, line: { color: C.white, width: 1 } });
    s.addText(`Ph ${i+1}`, { x: curX, y: barY, w: w, h: barH,
      fontSize: 11, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
    curX += w;
  });

  // Month ruler
  s.addShape(pres.ShapeType.rect, { x: barStartX, y: barY + barH, w: totalW, h: 0.04, fill: { color: C.muted } });
  for (let m = 0; m <= 30; m += 2) {
    const rx = barStartX + (m / 30) * totalW;
    s.addShape(pres.ShapeType.rect, { x: rx - 0.005, y: barY + barH, w: 0.01, h: 0.1, fill: { color: C.muted } });
    s.addText(`M${m}`, { x: rx - 0.2, y: barY + barH + 0.08, w: 0.4, h: 0.25,
      fontSize: 7, color: C.muted, align: "center", margin: 0 });
  }

  // Phase detail cards below
  const cardY = 2.75, cardH = 3.6;
  curX = 0.3;
  phases.forEach((ph, i) => {
    const w = 2.4;
    s.addShape(pres.ShapeType.roundRect, { x: curX, y: cardY, w: w, h: cardH,
      fill: { color: C.white }, line: { color: ph[3], width: 2 }, rectRadius: 0.12 });
    // Color header
    s.addShape(pres.ShapeType.roundRect, { x: curX, y: cardY, w: w, h: 0.7,
      fill: { color: ph[3] }, line: { color: ph[3], width: 0 }, rectRadius: 0.12 });
    s.addShape(pres.ShapeType.rect, { x: curX, y: cardY + 0.4, w: w, h: 0.3,
      fill: { color: ph[3] }, line: { color: ph[3], width: 0 } });
    s.addText(ph[0], { x: curX, y: cardY + 0.08, w: w, h: 0.55,
      fontSize: 15, bold: true, color: C.white, align: "center", margin: 0 });
    s.addText(ph[1], { x: curX, y: cardY + 0.72, w: w, h: 0.35,
      fontSize: 10, bold: true, color: ph[3], align: "center", margin: 0 });
    s.addText(ph[2], { x: curX, y: cardY + 1.05, w: w, h: 0.3,
      fontSize: 9, color: C.muted, align: "center", margin: 0 });
    // Divider
    s.addShape(pres.ShapeType.rect, { x: curX + 0.2, y: cardY + 1.42, w: w - 0.4, h: 0.02, fill: { color: "DDDDDD" } });
    s.addText(ph[4], { x: curX + 0.1, y: cardY + 1.55, w: w - 0.2, h: 1.0,
      fontSize: 9.5, color: C.navy, align: "center", wrap: true, margin: 0 });
    curX += w + 0.17;
  });

  // Bottom note
  s.addText("* Phase 3 targets the December 2027 FMGE as the primary first attempt. Phases 4 and 5 are contingency buffers.", {
    x: 0.4, y: 6.85, w: 12.5, h: 0.4,
    fontSize: 9, color: C.muted, italic: true, margin: 0
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 3 – PHASE 1: Month-by-month (Months 1–8)
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.lightBg } });
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 0.85, fill: { color: PHASE_COLORS[1] } });
  s.addText("Phase 1 — Foundation Building", {
    x: 0.4, y: 0.1, w: 9, h: 0.6, fontSize: 22, bold: true, color: C.white, margin: 0
  });
  s.addText("Months 1–8  |  Jul 2026 – Feb 2027", {
    x: 9.0, y: 0.18, w: 4.0, h: 0.45, fontSize: 12, color: C.white, align: "right", margin: 0
  });

  // Month cards data: [month, label, subject, book1 (standard), book2 (review), color, days]
  const months = [
    ["M1", "Jul 2026", "Anatomy", "BD Chaurasia (3 vols)\nor Vishram Singh", "Inderbir Singh\n(Quick Review)", "E63946", 30],
    ["M2", "Aug 2026", "Physiology", "AK Jain\n(Textbook)", "Sembulingam\n(Short), PYQs", "F4721E", 31],
    ["M3", "Sep 2026", "Biochemistry", "U Satyanarayana", "DM Vasudevan\n+ PYQs", "FFBF00", 30],
    ["M4", "Oct 2026", "Pathology", "Harsh Mohan", "Praveen Kumar\nGupta (Review)", "80B918", 31],
    ["M5", "Nov 2026", "Microbiology\n+ Forensic", "Ananthanarayan\n& Paniker /\nReddy's FM", "Apurba Sastry\n+ Anil Aggarwal", "2DC653", 30],
    ["M6", "Dec 2026", "Pharmacology", "KD Tripathi\n(Essentials)", "Gobind Rai Garg\n(PGMEE Pharma)", "118AB2", 31],
    ["M7", "Jan 2027", "Medicine", "Davidson's\n(Principles)", "Mudit Khanna\n(SAR Medicine)", "1B998B", 31],
    ["M8", "Feb 2027", "Surgery +\nOrtho", "Bailey & Love /\nMaheshwari", "Pritash Das /\nOPQR", "7B2D8B", 28],
  ];

  const colW = 1.52, colH = 5.5, startX = 0.28, startY = 1.1;

  months.forEach((m, i) => {
    const cx = startX + i * (colW + 0.04);
    // Card
    s.addShape(pres.ShapeType.roundRect, { x: cx, y: startY, w: colW, h: colH,
      fill: { color: C.white }, line: { color: m[6], width: 2 }, rectRadius: 0.1 });
    // Header
    s.addShape(pres.ShapeType.roundRect, { x: cx, y: startY, w: colW, h: 0.62,
      fill: { color: m[6] }, line: { color: m[6], width: 0 }, rectRadius: 0.1 });
    s.addShape(pres.ShapeType.rect, { x: cx, y: startY + 0.35, w: colW, h: 0.27,
      fill: { color: m[6] }, line: { color: m[6], width: 0 } });
    s.addText(m[0], { x: cx, y: startY + 0.02, w: colW, h: 0.3,
      fontSize: 13, bold: true, color: C.white, align: "center", margin: 0 });
    s.addText(m[1], { x: cx, y: startY + 0.32, w: colW, h: 0.28,
      fontSize: 8.5, color: C.white, align: "center", margin: 0 });
    // Subject name
    s.addText(m[2], { x: cx + 0.05, y: startY + 0.7, w: colW - 0.1, h: 0.65,
      fontSize: 10, bold: true, color: C.navy, align: "center", wrap: true, margin: 0 });
    // Divider
    s.addShape(pres.ShapeType.rect, { x: cx + 0.1, y: startY + 1.38, w: colW - 0.2, h: 0.02, fill: { color: "EEEEEE" } });
    // Standard book
    s.addText("📖 Standard", { x: cx + 0.05, y: startY + 1.45, w: colW - 0.1, h: 0.3,
      fontSize: 7.5, bold: true, color: C.teal, margin: 0 });
    s.addText(m[3], { x: cx + 0.05, y: startY + 1.72, w: colW - 0.1, h: 1.1,
      fontSize: 8, color: C.navy, wrap: true, margin: 0 });
    // Review book
    s.addShape(pres.ShapeType.rect, { x: cx + 0.1, y: startY + 2.88, w: colW - 0.2, h: 0.02, fill: { color: "EEEEEE" } });
    s.addText("🎯 Review", { x: cx + 0.05, y: startY + 2.94, w: colW - 0.1, h: 0.3,
      fontSize: 7.5, bold: true, color: C.orange, margin: 0 });
    s.addText(m[4], { x: cx + 0.05, y: startY + 3.2, w: colW - 0.1, h: 1.0,
      fontSize: 8, color: C.navy, wrap: true, margin: 0 });
    // Days badge
    s.addShape(pres.ShapeType.ellipse, { x: cx + colW/2 - 0.3, y: startY + colH - 0.55, w: 0.6, h: 0.38,
      fill: { color: m[6] }, line: { color: m[6], width: 0 } });
    s.addText(`${m[5]}d`, { x: cx + colW/2 - 0.3, y: startY + colH - 0.55, w: 0.6, h: 0.38,
      fontSize: 8, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
  });

  // Bottom tip
  s.addText("Tip: Solve 50 subject-wise MCQs daily after each chapter. Make one-liner notes as you go — these become your revision bible.", {
    x: 0.28, y: 6.95, w: 12.7, h: 0.35,
    fontSize: 9, color: C.muted, italic: true, margin: 0
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 4 – PHASE 2: Months 9–14 (Clinical subjects)
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.lightBg } });
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 0.85, fill: { color: PHASE_COLORS[2] } });
  s.addText("Phase 2 — Clinical Subjects + Integration", {
    x: 0.4, y: 0.1, w: 9, h: 0.6, fontSize: 22, bold: true, color: C.white, margin: 0
  });
  s.addText("Months 9–14  |  Mar 2027 – Aug 2027", {
    x: 8.8, y: 0.18, w: 4.2, h: 0.45, fontSize: 12, color: C.white, align: "right", margin: 0
  });

  const months = [
    ["M9", "Mar 2027", "OBG", "DC Dutta (Obs)\n+\nShaw's (Gynae)", "Sakshi Arora\nOBG Review\n+ PYQs", "D7263D", 31],
    ["M10", "Apr 2027", "Paediatrics", "OP Ghai\n(Essential\nPediatrics)", "Jitendra Talekar\nNotes /\nPiyush Gupta", "7B2D8B", 30],
    ["M11", "May 2027", "Community\nMedicine", "Park's (PSM)\n— full cover", "Vivek Jain\nReview PSM\n+ PYQs", "1B998B", 31],
    ["M12", "Jun 2027", "ENT +\nOphthalmology", "Dhingra (ENT)\n+\nAK Khurana (Oph)", "Sakshi Arora ENT\n+\nDr Ruchi Rai", "118AB2", 30],
    ["M13", "Jul 2027", "Psychiatry +\nDerm + Anaes\n+ Radiology", "Ahuja Psychiatry\n+ Saurabh Jindal\n+ Anesthesia Ess.", "Compact reviews\n+ PYQs for all\n4 subjects", "F4721E", 31],
    ["M14", "Aug 2027", "FULL REVISION\n(All Subjects)", "Short notes\nonly — no\nnew textbooks", "PYQ papers\n2020–2025\n(full papers)", "0D1B2A", 31],
  ];

  const colW = 2.08, colH = 5.5, startX = 0.22, startY = 1.05;

  months.forEach((m, i) => {
    const cx = startX + i * (colW + 0.06);
    s.addShape(pres.ShapeType.roundRect, { x: cx, y: startY, w: colW, h: colH,
      fill: { color: C.white }, line: { color: m[6], width: 2 }, rectRadius: 0.1 });
    s.addShape(pres.ShapeType.roundRect, { x: cx, y: startY, w: colW, h: 0.62,
      fill: { color: m[6] }, line: { color: m[6], width: 0 }, rectRadius: 0.1 });
    s.addShape(pres.ShapeType.rect, { x: cx, y: startY + 0.35, w: colW, h: 0.27,
      fill: { color: m[6] }, line: { color: m[6], width: 0 } });
    s.addText(m[0], { x: cx, y: startY + 0.02, w: colW, h: 0.3,
      fontSize: 13, bold: true, color: C.white, align: "center", margin: 0 });
    s.addText(m[1], { x: cx, y: startY + 0.32, w: colW, h: 0.28,
      fontSize: 8.5, color: C.white, align: "center", margin: 0 });
    s.addText(m[2], { x: cx + 0.05, y: startY + 0.7, w: colW - 0.1, h: 0.7,
      fontSize: 10, bold: true, color: C.navy, align: "center", wrap: true, margin: 0 });
    s.addShape(pres.ShapeType.rect, { x: cx + 0.1, y: startY + 1.44, w: colW - 0.2, h: 0.02, fill: { color: "EEEEEE" } });
    s.addText("📖 Standard", { x: cx + 0.05, y: startY + 1.5, w: colW - 0.1, h: 0.28,
      fontSize: 7.5, bold: true, color: C.teal, margin: 0 });
    s.addText(m[3], { x: cx + 0.05, y: startY + 1.75, w: colW - 0.1, h: 1.1,
      fontSize: 8.5, color: C.navy, wrap: true, margin: 0 });
    s.addShape(pres.ShapeType.rect, { x: cx + 0.1, y: startY + 2.9, w: colW - 0.2, h: 0.02, fill: { color: "EEEEEE" } });
    s.addText("🎯 Review / MCQs", { x: cx + 0.05, y: startY + 2.97, w: colW - 0.1, h: 0.28,
      fontSize: 7.5, bold: true, color: C.orange, margin: 0 });
    s.addText(m[4], { x: cx + 0.05, y: startY + 3.22, w: colW - 0.1, h: 1.1,
      fontSize: 8.5, color: C.navy, wrap: true, margin: 0 });
    s.addShape(pres.ShapeType.ellipse, { x: cx + colW/2 - 0.3, y: startY + colH - 0.55, w: 0.6, h: 0.38,
      fill: { color: m[6] }, line: { color: m[6], width: 0 } });
    s.addText(`${m[5]}d`, { x: cx + colW/2 - 0.3, y: startY + colH - 0.55, w: 0.6, h: 0.38,
      fontSize: 8, bold: true, color: m[6] === "0D1B2A" ? C.teal : C.white, align: "center", valign: "middle", margin: 0 });
  });

  s.addText("Key shift: Start weekly full mock tests from M12. Target mock score above 120 before Phase 3 begins.", {
    x: 0.22, y: 6.95, w: 12.8, h: 0.35,
    fontSize: 9, color: C.muted, italic: true, margin: 0
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 5 – PHASE 3 & 4 Sprint Plans
// ═══════════════════════════════════════════════════════════════════════════════
{
  const s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.navy } });

  // Left panel – Phase 3
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 6.5, h: 7.5, fill: { color: "0F2744" } });
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 6.5, h: 0.85, fill: { color: PHASE_COLORS[3] } });
  s.addText("Phase 3 — 1st Attempt Sprint", {
    x: 0.2, y: 0.1, w: 6.1, h: 0.6, fontSize: 18, bold: true, color: C.white, margin: 0
  });

  // Right panel – Phase 4
  s.addShape(pres.ShapeType.rect, { x: 6.6, y: 0, w: 6.7, h: 0.85, fill: { color: PHASE_COLORS[4] } });
  s.addText("Phase 4 — Review + 2nd Attempt", {
    x: 6.8, y: 0.1, w: 6.3, h: 0.6, fontSize: 18, bold: true, color: C.white, margin: 0
  });

  // Phase 3 details
  const p3 = [
    ["M15", "Sep 2027", "2nd full revision — short notes only. Priority: Medicine, Surgery, OBG, PSM. Solve 100 MCQs/day."],
    ["M16", "Oct 2027", "Weak subject intensive. PYQs 2022–2025 (all papers). 2 full mock tests per week. Error journal."],
    ["M17", "Nov 2027", "3–4 full mock tests/week under real exam time. Section-wise analysis after each mock."],
    ["M18", "Dec 2027", "Final 2 weeks: HIGH-YIELD one-liners only. National health programs cheat sheet. Rest before exam."],
  ];
  p3.forEach((row, i) => {
    const ry = 1.05 + i * 1.42;
    s.addShape(pres.ShapeType.roundRect, { x: 0.2, y: ry, w: 6.1, h: 1.3,
      fill: { color: "1A3557" }, line: { color: PHASE_COLORS[3], width: 1 }, rectRadius: 0.1 });
    s.addShape(pres.ShapeType.roundRect, { x: 0.2, y: ry, w: 1.05, h: 1.3,
      fill: { color: PHASE_COLORS[3] }, line: { color: PHASE_COLORS[3], width: 0 }, rectRadius: 0.1 });
    s.addShape(pres.ShapeType.rect, { x: 0.9, y: ry, w: 0.35, h: 1.3,
      fill: { color: PHASE_COLORS[3] }, line: { color: PHASE_COLORS[3], width: 0 } });
    s.addText(row[0], { x: 0.2, y: ry + 0.1, w: 1.05, h: 0.4,
      fontSize: 14, bold: true, color: C.white, align: "center", margin: 0 });
    s.addText(row[1], { x: 0.2, y: ry + 0.52, w: 1.05, h: 0.5,
      fontSize: 8, color: C.white, align: "center", margin: 0 });
    s.addText(row[2], { x: 1.35, y: ry + 0.12, w: 4.85, h: 1.1,
      fontSize: 9.5, color: C.white, wrap: true, margin: 0 });
  });

  // Phase 4 details
  const p4 = [
    ["M19", "Jan 2028", "Post-exam analysis: classify wrong answers by subject. Create a gap list."],
    ["M20", "Feb 2028", "Deep-dive into top 3 weak subjects from December attempt. Standard book + PYQs."],
    ["M21", "Mar 2028", "Community Medicine intensive (30 marks — highest ROI). Full Park's revision."],
    ["M22", "Apr 2028", "Full revision cycle #3. All subjects via short notes. 2 mocks/week."],
    ["M23", "May 2028", "3–4 mocks/week. Target 160+ consistently before the exam."],
    ["M24", "Jun 2028", "Final week: one-liners + health program data. Attempt FMGE June 2028."],
  ];
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}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 6 – DAILY STUDY SCHEDULE + WEEKLY PATTERN
// ═══════════════════════════════════════════════════════════════════════════════
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  const blocks = [
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    ["8:00–9:00 AM", "MCQ Drill", "50 MCQs on yesterday's topic (Qbank)", C.sky],
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    ["1:00–2:00 PM", "Lunch + Rest", "Short nap if needed — improves memory consolidation", "AAAAAA"],
    ["2:00–4:00 PM", "MCQ Practice", "50 MCQs on today's topic + review wrong answers", C.orange],
    ["4:00–5:00 PM", "PYQ Session", "Previous year questions — subject of the day", C.purple],
    ["5:00–6:00 PM", "Break + Exercise", "Walk, sport, or gym", "AAAAAA"],
    ["7:00–9:00 PM", "Revision Block", "Re-read notes from the past 7 days (spaced repetition)", C.gold === "FFBF00" ? "B8860B" : C.gold],
    ["9:00–9:30 PM", "Flashcard Review", "Anki or handwritten cards — 30 high-yield facts", C.lime],
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    ["MON", "New Subject — Read + MCQs (100 Qs)", C.teal],
    ["TUE", "Continue Subject — Notes + MCQs (100 Qs)", C.teal],
    ["WED", "Complete Subject — PYQs from this subject", C.sky],
    ["THU", "New Subject — Read + MCQs (100 Qs)", C.teal],
    ["FRI", "Continue Subject — Notes + MCQs (100 Qs)", C.teal],
    ["SAT", "Mixed MCQs (last 2 subjects) — 150 Qs", C.orange],
    ["SUN", "Full Mock Test (Phase 2+) OR Weak-topic revision", C.purple],
  ];
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// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 7 – SUBJECT PRIORITY + BOOKS QUICK-REF TABLE
// ═══════════════════════════════════════════════════════════════════════════════
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  const rows = [
    ["General Medicine", "33", "M7", "Davidson's Principles", "Mudit Khanna SAR", "🔴 CRITICAL"],
    ["General Surgery", "32", "M8", "Bailey & Love", "Pritash Das PGMEE", "🔴 CRITICAL"],
    ["Community Med (PSM)", "30", "M11", "Park's Textbook", "Vivek Jain Review", "🔴 CRITICAL"],
    ["OBG", "30", "M9", "DC Dutta + Shaw's", "Sakshi Arora Review", "🔴 CRITICAL"],
    ["Anatomy", "17", "M1", "Vishram Singh", "Inderbir Singh", "🟠 HIGH"],
    ["Physiology", "17", "M2", "AK Jain", "Sembulingam", "🟠 HIGH"],
    ["Biochemistry", "17", "M3", "U Satyanarayana", "DM Vasudevan", "🟠 HIGH"],
    ["Pathology", "13", "M4", "Harsh Mohan", "Praveen Kumar Gupta", "🟠 HIGH"],
    ["Microbiology", "13", "M5", "Ananthanarayan & Paniker", "Apurba Sastry", "🟠 HIGH"],
    ["Pharmacology", "13", "M6", "KD Tripathi", "Gobind Rai Garg", "🟠 HIGH"],
    ["Paediatrics", "15", "M10", "OP Ghai", "Jitendra Talekar Notes", "🟡 MEDIUM"],
    ["ENT", "15", "M12", "Dhingra", "Sakshi Arora ENT", "🟡 MEDIUM"],
    ["Ophthalmology", "15", "M12", "AK Khurana", "Dr Ruchi Rai Review", "🟡 MEDIUM"],
    ["Forensic Medicine", "10", "M5", "Reddy's", "Anil Aggarwal Review", "🟡 MEDIUM"],
    ["Psychiatry", "5", "M13", "Ahuja (Short)", "Arvind Patel PGMEE", "🟢 LOW"],
    ["Dermatology & STD", "5", "M13", "IADVL Textbook (select)", "Saurabh Jindal Review", "🟢 LOW"],
    ["Orthopaedics", "5", "M8", "Maheshwari Essential", "OPQR — Apurv Mehra", "🟢 LOW"],
    ["Anaesthesia", "5", "M13", "Morgan & Mikhail (select)", "Anesthesia Essence", "🟢 LOW"],
    ["Radiodiagnosis", "5", "M13", "Sutton's (select ch.)", "Rajat & Virendra Jain", "🟢 LOW"],
  ];

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    "🔴 CRITICAL": "FFF0F0",
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    "🟡 MEDIUM":   "FDFDE8",
    "🟢 LOW":      "F0FFF4",
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    "🔴 CRITICAL": "C0392B",
    "🟠 HIGH":     "D35400",
    "🟡 MEDIUM":   "B7950B",
    "🟢 LOW":      "1E8449",
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// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 8 – KEY MILESTONES + TIPS
// ═══════════════════════════════════════════════════════════════════════════════
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  // Milestones (left)
  const milestones = [
    ["Feb 2027", "Complete 1st pass of all 19 subjects", PHASE_COLORS[1]],
    ["May 2027", "First full mock score above 120/300", PHASE_COLORS[2]],
    ["Aug 2027", "Full-paper PYQs 2020–2025 completed", PHASE_COLORS[2]],
    ["Oct 2027", "Consistent mock scores above 140/300", PHASE_COLORS[3]],
    ["Dec 2027", "1st FMGE Attempt — Target: PASS", PHASE_COLORS[3]],
    ["Mar 2028", "Post-attempt gap analysis complete", PHASE_COLORS[4]],
    ["Jun 2028", "2nd FMGE Attempt (if needed)", PHASE_COLORS[4]],
    ["Dec 2028", "3rd attempt buffer (safety net)", PHASE_COLORS[5]],
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    ["No Negative Marking", "Never leave any question blank — always guess if unsure. A random guess gives 25% chance."],
    ["Time-Bound Sections", "New 2026 format has timed sections within each part. Practice with a timer every mock."],
    ["Clinical Q Approach", "Read the final line (actual question) first, then read the stem to avoid misdirection."],
    ["PSM Cheat Sheet", "Carry a mental table of immunization schedules, vitamin deficiencies, disease incubation periods."],
    ["Image-Based Qs", "~15–20 questions are image-based. Practice ECG, X-ray, and dermatology photos from PYQs."],
    ["Flagging System", "Answer what you know, flag uncertain ones, return to them — don't get stuck mid-paper."],
    ["Part A vs Part B", "Part A (100 Qs) = 2.5 hrs. Part B (200 Qs) = 2.5 hrs. Adjust pace: ~1.5 min/Q for Part B."],
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// ─── Write file ───────────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/fmge-timeline/FMGE_30Month_Study_Timeline.pptx" })
  .then(() => console.log("DONE: /home/daytona/workspace/fmge-timeline/FMGE_30Month_Study_Timeline.pptx"))
  .catch(e => { console.error(e); process.exit(1); });

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/fmge-timeline/generate.js'

"use strict";
const pptxgen = require("pptxgenjs");
const pres = new pptxgen();
pres.layout = "LAYOUT_WIDE"; // 13.3" × 7.5"
pres.title = "FMGE High-Yield Topic Cheat Sheets";

// ── Palette ──────────────────────────────────────────────────────────────────
const W = "FFFFFF", NK = "0D1B2A", MUT = "7A8FA6";

// Each subject: { title, marks, color (hex), accent (hex), cols: [[heading, items[]],...] }
const SUBJECTS = [
  {
    title: "ANATOMY", marks: 17, color: "B5213A", accent: "FADADD",
    cols: [
      { h: "Embryology — Must-Know", items: [
        "Pharyngeal arches: 1st→mandible/malleus/incus, 2nd→stapes/styloid, 3rd→stylopharyngeus",
        "Neural crest derivatives: melanocytes, adrenal medulla, ganglia, DRG, Schwann cells",
        "Notochord → nucleus pulposus",
        "Branchial fistula: persistent cervical sinus (2nd arch failure)",
        "Meconium ileus: cystic fibrosis association",
        "Hirschsprung: failure of neural crest migration → aganglionic segment",
        "Septum secundum: foramen ovale; defect → ASD",
        "Ductus arteriosus closes via PGE2 withdrawal (indomethacin closes it)",
        "Cauda equina = NOT neural crest",
      ]},
      { h: "Neuroanatomy High-Yield", items: [
        "LMN facial palsy: ALL muscles ipsilateral (forehead spared in UMN)",
        "UMN lesion: forehead sparing, hyperreflexia, spasticity",
        "Brachial plexus roots: C5–T1; Erb's C5–C6 (waiter's tip), Klumpke C8–T1",
        "Horner's syndrome: ptosis + miosis + anhidrosis (C8–T1 lesion)",
        "Circle of Willis: ACA communicates via AcomA; PCA via PcomA",
        "Dorsal column (PCML): ipsilateral below lesion; vibration + proprioception",
        "Spinothalamic tract: contralateral; pain + temperature",
        "Cerebellar lesions: ipsilateral signs, intention tremor, dysdiadochokinesia",
        "10th cranial nerve (vagus): only CN to exit via jugular foramen with IX, XI",
      ]},
      { h: "Clinical Anatomy Pearls", items: [
        "McBurney's point: 1/3 from ASIS to umbilicus → appendix",
        "Hesselbach's triangle: inferior epigastric artery + inguinal lig + rectus sheath",
        "Femoral canal: contains fat + lymphatics; medial to femoral vein",
        "Carpal tunnel: median nerve compressed → thenar wasting + lateral 3½ fingers",
        "Cubital tunnel: ulnar nerve → ring/little finger + intrinsic muscles",
        "Radial nerve: Saturday night palsy → wrist drop",
        "Axillary nerve: surgical neck fracture → deltoid paralysis",
        "Liver segments: Couinaud — 8 segments; segment I = caudate lobe",
        "Elastic cartilage: ear pinna, epiglottis, auditory tube (Eustachian)",
      ]},
    ]
  },

  {
    title: "PHYSIOLOGY", marks: 17, color: "1A5276", accent: "D6EAF8",
    cols: [
      { h: "CVS Physiology", items: [
        "Normal cardiac output: 5 L/min; CI = CO/BSA (normal 2.5–4 L/min/m²)",
        "Starling's law: stretch → increased force (up to a point)",
        "JVP: 'a' wave = atrial contraction; 'c' = tricuspid bulge; 'v' = venous filling",
        "Jugular venous pressure: absent 'a' wave → AF; cannon 'a' waves → CHB",
        "QRS > 0.12 sec = bundle branch block; RBBB: RSR' in V1",
        "SA node pacemaker: phase 4 spontaneous depolarization (funny current If)",
        "AV node: only conducting pathway between atria and ventricles normally",
        "Korotkoff sounds: Phase I = systolic BP; Phase V = diastolic BP",
        "Coronary blood flow: max in diastole for LV (unlike RV)",
      ]},
      { h: "Respiratory + Renal", items: [
        "FRC = RV + ERV; cannot be measured by spirometry (needs helium dilution)",
        "Hypoxic vasoconstriction: unique to pulmonary vasculature",
        "Normal PaO2: 80–100 mmHg; PaCO2: 35–45 mmHg",
        "Haldane effect: oxygenation of Hb releases CO2",
        "Bohr effect: ↑CO2/↑H+ → right shift of O2-Hb curve (↓affinity)",
        "Clearance formula: C = UV/P (inulin = GFR marker, gold standard)",
        "GFR ~125 mL/min; filtered load = GFR × plasma conc.",
        "Aldosterone: acts on collecting duct, Na+ reabsorption, K+ secretion",
        "ADH: V2 receptors → aquaporin 2 insertion → water reabsorption",
        "Countercurrent mechanism: loop of Henle creates medullary gradient",
      ]},
      { h: "Neuro + Endocrine", items: [
        "Resting membrane potential: –70 mV (maintained by Na+/K+ ATPase)",
        "Action potential: Na+ in (depolarization) → K+ out (repolarization)",
        "Absolute refractory period: Na+ channels inactivated — cannot fire",
        "Neuromuscular junction: ACh → nicotinic receptors → end-plate potential",
        "Insulin: secreted by β cells; glucose uptake in muscle/fat; inhibits glucagon",
        "Glucagon: α cells; glycogenolysis + gluconeogenesis; counters insulin",
        "Cortisol: anti-inflammatory, gluconeogenesis, immunosuppression",
        "TSH stimulates T3/T4; T3 more active than T4 (T4 → T3 peripherally)",
        "Growth hormone: IGF-1 mediated anabolic effects; peaks in sleep",
        "Oxytocin: milk ejection reflex + uterine contraction (Ferguson reflex)",
      ]},
    ]
  },

  {
    title: "BIOCHEMISTRY", marks: 17, color: "117A65", accent: "D5F5E3",
    cols: [
      { h: "Vitamins — Classic Deficiencies", items: [
        "Vit A (retinol): night blindness, Bitot's spots, xerophthalmia, keratomalacia",
        "Vit B1 (thiamine): Wernicke's encephalopathy, beriberi (wet/dry)",
        "Vit B2 (riboflavin): angular stomatitis, corneal vascularization, magenta tongue",
        "Vit B3 (niacin): pellagra — 4 Ds: Dermatitis, Diarrhea, Dementia, Death",
        "Vit B6 (pyridoxine): sideroblastic anemia; deficiency with INH (give B6 supplement)",
        "Vit B12 (cobalamin): megaloblastic anemia + subacute combined degeneration",
        "Vit C (ascorbic acid): scurvy — perifollicular hemorrhage, corkscrew hair",
        "Vit D (cholecalciferol): rickets (children), osteomalacia (adults)",
        "Vit E: hemolytic anemia in premature neonates; ataxia",
        "Vit K: bleeding disorder; needed for factors II, VII, IX, X (warfarin blocks it)",
      ]},
      { h: "Metabolism High-Yield", items: [
        "Glycolysis: glucose → 2 pyruvate; net 2 ATP; occurs in cytoplasm",
        "Krebs cycle: acetyl-CoA enters; produces 3 NADH, 1 FADH2, 1 GTP per turn",
        "Electron transport chain: NADH → 2.5 ATP; FADH2 → 1.5 ATP",
        "Fatty acid oxidation (β-oxidation): mitochondria; carnitine shuttle needed",
        "HMP shunt: glucose-6-P → NADPH (for RBC/GSH); G6PD deficiency → hemolysis",
        "Urea cycle: liver only; ornithine → citrulline → argininosuccinate → arginine → urea",
        "Phenylketonuria: phenylalanine hydroxylase deficiency; musty odor, intellectual disability",
        "Homocystinuria: CBS deficiency; lens dislocation downward (Marfan: upward)",
        "Glycogen storage diseases: von Gierke (I) — G6Pase; Pompe (II) — acid maltase",
        "LDL receptor deficiency: familial hypercholesterolemia; tendon xanthomas",
      ]},
      { h: "Enzymes + Molecular Biology", items: [
        "Michaelis-Menten: Km = substrate at half Vmax; low Km = high affinity",
        "Competitive inhibition: ↑Km, same Vmax; overcome by excess substrate",
        "Non-competitive inhibition: same Km, ↓Vmax; cannot be overcome",
        "DNA replication: semiconservative; primase → RNA primer; DNA pol III extends",
        "Transcription: RNA pol II → mRNA; rifampicin inhibits bacterial RNA pol",
        "Translation: ribosome reads 5'→3'; start codon AUG; stop: UAA, UAG, UGA",
        "Restriction enzymes cut at palindromic sequences (used in recombinant DNA)",
        "PCR: denature → anneal (primers) → extend (Taq polymerase); exponential amplification",
        "Southern blot: DNA; Northern: RNA; Western: protein; ELISA: antigen/antibody",
        "Lac operon: negative control; repressor removed by allolactose (inducer)",
      ]},
    ]
  },

  {
    title: "PATHOLOGY", marks: 13, color: "6C3483", accent: "E8DAEF",
    cols: [
      { h: "Cell Injury + Inflammation", items: [
        "Reversible injury: cell swelling (↑Na+/H2O), fatty change — mitochondria swell",
        "Irreversible: nuclear changes — pyknosis → karyorrhexis → karyolysis",
        "Coagulative necrosis: ischemia (except brain); architecture preserved",
        "Liquefactive necrosis: brain infarct + bacterial/fungal abscess",
        "Caseous necrosis: TB (cheese-like); granuloma with central necrosis",
        "Fat necrosis: pancreas (enzymatic); breast trauma (saponification)",
        "Fibrinoid necrosis: vasculitis, malignant hypertension, immune complex",
        "Acute inflammation: 5 cardinal signs; neutrophils predominate (first 24 hrs)",
        "Chronic inflammation: macrophages/lymphocytes; granuloma = epithelioid macrophages",
        "Granuloma types: caseating (TB, leprosy, fungi), non-caseating (sarcoid, Crohn's)",
      ]},
      { h: "Neoplasia + Tumor Markers", items: [
        "Benign: well-differentiated, encapsulated, no invasion/metastasis",
        "Malignant: pleomorphism, high N:C ratio, atypical mitoses, invasion",
        "Carcinoma in situ: full-thickness epithelial dysplasia, BM intact",
        "Oncogenes: RAS (most common), MYC, HER-2/neu; gain of function mutation",
        "Tumor suppressors: RB (retinoblastoma), P53 (guardian of genome), BRCA",
        "AFP: hepatocellular carcinoma + yolk sac tumor",
        "β-hCG: choriocarcinoma + testicular teratoma",
        "PSA: prostate cancer (screening)",
        "CEA: colon, pancreatic, gastric carcinoma (non-specific)",
        "CA-125: ovarian cancer; CA 19-9: pancreatic cancer",
      ]},
      { h: "Haematology + Systemic", items: [
        "Iron deficiency anemia: microcytic hypochromic; ↓ferritin, ↑TIBC",
        "B12/folate: megaloblastic; hypersegmented neutrophils; B12 → neuro signs",
        "Sickle cell: HbS (Glu→Val at pos 6 of β chain); crisis with hypoxia/dehydration",
        "Thalassemia: quantitative Hb defect; α-thal: Asians; β-thal: Mediterranean",
        "Hereditary spherocytosis: spectrin/ankyrin defect; splenomegaly; MCHC ↑",
        "G6PD deficiency: X-linked; Heinz bodies; triggered by oxidative stress",
        "DIC: widespread microthrombi + bleeding; ↓fibrinogen, ↑D-dimer, ↑PT/aPTT",
        "TTP: thrombocytopenia + microangiopathic hemolytic anemia + neuro + fever + renal",
        "Reed-Sternberg cells: Hodgkin's lymphoma (owl-eye appearance)",
        "Philadelphia chromosome t(9;22): BCR-ABL → CML (treated with imatinib)",
      ]},
    ]
  },

  {
    title: "MICROBIOLOGY", marks: 13, color: "784212", accent: "FDEBD0",
    cols: [
      { h: "Bacteria — High-Yield", items: [
        "TB (M. tuberculosis): acid-fast bacillus; Ghon complex (1°); Ranke complex (1° + LN)",
        "TB treatment: RIPE × 2 months → RI × 4 months (DOTS strategy)",
        "Leprosy: M. leprae; tuberculoid (paucibacillary) vs lepromatous (multibacillary)",
        "Cholera: V. cholerae; rice-water stools; CT activates Gs → ↑cAMP → Cl− secretion",
        "Typhoid: S. typhi; rose spots; Widal test; Faget's sign (relative bradycardia)",
        "Brucellosis: undulant fever; from cattle/goats; doxycycline + rifampicin",
        "Leptospirosis: Weil's disease; jaundice + AKI + hemorrhage; spirochete",
        "Diphtheria: C. diphtheriae; bull-neck; pseudomembrane; treat with antitoxin + penicillin",
        "Tetanus: C. tetani; spastic paralysis; disinhibition; metronidazole + TIG",
        "Botulism: descending flaccid paralysis; anti-toxin; no fever",
      ]},
      { h: "Virology + Parasitology", items: [
        "HIV: RNA virus; CD4 threshold: < 200 = AIDS; ELISA screen → Western blot confirm",
        "HIV OIs: PCP (CD4 < 200), CMV retinitis (< 50), MAC (< 50), toxoplasma (< 100)",
        "Hepatitis B: HBsAg (surface, 1st to appear); anti-HBs (immunity); HBeAg (infectivity)",
        "Hepatitis C: MC cause of post-transfusion hepatitis; chronic in 80%; RNA virus",
        "Rabies: Negri bodies (hippocampus/cerebellum); fixed virus (CVS); street virus",
        "Dengue: Aedes aegypti; thrombocytopenia + plasma leak; NS1 antigen test",
        "Malaria: P. falciparum → cerebral malaria + blackwater fever; thick smear = diagnosis",
        "P. vivax/ovale: dormant hypnozoites (liver); treat with primaquine",
        "Kala-azar (Leishmania donovani): splenomegaly + fever + pancytopenia; rK39 test",
        "Filariasis: Wuchereria bancrofti; lymphedema; microfilariae nocturnal periodicity",
      ]},
      { h: "Immunology Essentials", items: [
        "Primary response: IgM first (5–7 days); secondary: IgG faster + higher titre",
        "IgA: secretory Ig; mucosal immunity; dimer in secretions",
        "IgE: allergy + parasites; binds mast cells + basophils",
        "MHC I: on all nucleated cells; presents to CD8+ CTL",
        "MHC II: APC (DC, B cells, macrophages); presents to CD4+ T-helper",
        "Complement: C3 = most abundant; C3b = opsonin; C5a = chemotaxis + anaphylatoxin",
        "Type I hypersensitivity: IgE-mediated; mast cell degranulation (anaphylaxis, asthma)",
        "Type II: cytotoxic; antibody against cell surface (hemolytic anemia, myasthenia)",
        "Type III: immune complex; serum sickness, SLE, post-strep GN",
        "Type IV: delayed (T-cell mediated); tuberculin test, contact dermatitis, graft rejection",
      ]},
    ]
  },

  {
    title: "PHARMACOLOGY", marks: 13, color: "1F618D", accent: "D6EAF8",
    cols: [
      { h: "Autonomic Nervous System", items: [
        "Cholinergic (muscarinic): SLUDD + bradycardia; atropine blocks (mydriasis, dry mouth)",
        "Adrenaline: α+β agonist; first drug in anaphylaxis (IM 0.5 mg)",
        "Beta-blockers: propranolol (non-selective); atenolol (β1-selective); contraindicated in asthma",
        "Organophosphate poisoning: SLUDGE; treat with atropine + pralidoxime (2-PAM)",
        "Myasthenia gravis: neostigmine (anti-ChE); diagnosis: Tensilon (edrophonium) test",
        "Depolarizing NMJ blocker: succinylcholine (suxamethonium) — fasciculations first",
        "Non-depolarizing: curare/rocuronium; reversed by neostigmine",
        "Phentolamine: alpha blocker → used in pheochromocytoma",
        "Clonidine: central α2 agonist → ↓sympathetic outflow → ↓BP",
      ]},
      { h: "CVS + CNS Drugs", items: [
        "Digoxin toxicity: yellow vision, heart block; treat with digibind; corrects K+",
        "Amiodarone: class III; multiple SEs — thyroid, pulmonary, liver, skin (photosensitivity)",
        "Heparin: immediate anticoagulation; antidote = protamine sulfate",
        "Warfarin: vitamin K antagonist; antidote = Vit K / FFP; monitor with PT/INR",
        "Aspirin: irreversibly inhibits COX-1/2; ↓TXA2 → antiplatelet",
        "Morphine: mu-opioid agonist; constipation, respiratory depression; antidote = naloxone",
        "Benzodiazepines: GABA-A potentiation; antidote = flumazenil",
        "Phenytoin: Na+ channel blocker; zero-order kinetics; gingival hyperplasia, hirsutism",
        "Carbamazepine: trigeminal neuralgia; SIADH; induces CYP450",
        "Lithium: bipolar mood disorder; narrow TI; monitor levels; tremor, hypothyroidism",
      ]},
      { h: "Antimicrobials + Chemotherapy", items: [
        "Penicillin: inhibits cell wall synthesis (transpeptidase); bactericidal",
        "Aminoglycosides: irreversible binding 30S; nephrotoxic + ototoxic; monitor trough",
        "Tetracyclines: 30S binding; chelate Ca2+ → avoid in children/pregnancy; photosensitivity",
        "Chloramphenicol: 50S; grey baby syndrome; aplastic anemia; hepatic glucuronidation",
        "Quinolones: inhibit DNA gyrase (topo II); avoid with antacids (chelation)",
        "Metronidazole: anaerobes + protozoa; disulfiram reaction with alcohol",
        "Rifampicin: RNA pol inhibitor; red-orange urine; strong enzyme inducer",
        "Anti-TB: INH (B6 deficiency, hepatotoxicity); PZA (gout); ethambutol (optic neuritis)",
        "Cyclophosphamide: alkylating agent; hemorrhagic cystitis (give mesna)",
        "Methotrexate: folate antagonist; mucositis; rescue with leucovorin; teratogenic",
      ]},
    ]
  },

  {
    title: "FORENSIC MEDICINE", marks: 10, color: "2C3E50", accent: "D5D8DC",
    cols: [
      { h: "Post-Mortem Changes", items: [
        "Algor mortis: body cools ~1°C/hr; complete in 24 hrs (ambient 21°C)",
        "Rigor mortis: starts 3–6 hrs; maximum 12 hrs; passes off 36–48 hrs",
        "Rigor mortis: starts jaw/neck → downward; passes off same order",
        "Cadaveric lividity (livor mortis): starts 30 min–2 hrs; fixed after 8–12 hrs",
        "Putrefaction: green discoloration iliac fossa first (8–12 hrs); bloating",
        "Adipocere: saponification of fat; moist environment; delays putrefaction",
        "Mummification: dry hot environment; dehydration of body",
        "Brain: most susceptible to putrefaction; uterus: most resistant",
      ]},
      { h: "Poisoning — Forensic", items: [
        "OPC (organophosphate): cholinergic crisis; SLUDGE; miosis; garlic odor",
        "Arsenic: garlic odor; Mees' lines (nails); rain-drop pigmentation",
        "Lead: blue line on gums (Burton's line); wrist/foot drop; basophilic stippling",
        "Carbon monoxide: cherry-red skin/mucosa; carboxyhemoglobin; treat O2 (100%)",
        "Cyanide: bitter almond smell; cellular hypoxia (histotoxic); treat with hydroxocobalamin",
        "Dhatura (atropine): anticholinergic syndrome; hot dry flushed skin; dry mouth",
        "Aconite: numb-tingling lips; heart toxin; no specific antidote",
        "Abrus precatorius (rosary pea): abrin toxin; cell death",
        "Opium/morphine: pinpoint pupils; respiratory depression; naloxone antidote",
      ]},
      { h: "IPC Sections + Injuries", items: [
        "IPC 302: murder; IPC 304A: culpable homicide not amounting to murder",
        "IPC 304B: dowry death (within 7 years of marriage)",
        "IPC 376: rape; IPC 377: unnatural offences",
        "IPC 312: causing miscarriage; IPC 313: without consent of woman",
        "MLC: includes all injuries, poisoning, sexual offences, deaths in custody",
        "Contusion (bruise): blunt force; can indicate time of death from colour changes",
        "Incised wound: sharp clean edges; long > deep; no bruising",
        "Laceration: blunt force; irregular edges; tissue bridges; contamination",
        "Stab wound: pointed weapon; depth > length; tailing on one edge",
        "Hesitation cuts: suicide; multiple superficial parallel cuts",
      ]},
    ]
  },

  {
    title: "GENERAL MEDICINE", marks: 33, color: "1A5276", accent: "D6EAF8",
    cols: [
      { h: "Cardiology", items: [
        "MI: STEMI → PCI within 90 min (door-balloon); fibrinolysis if PCI not available",
        "Earliest cardiac marker: heart-type FABP (fatty acid binding protein)",
        "Troponin: rises 3–6 hrs, peaks 12–24 hrs, stays up 7–10 days",
        "Heart failure: EF < 40% = HFrEF; ACEi + beta-blocker + spironolactone",
        "Mitral stenosis: rheumatic fever MC cause; opening snap; mid-diastolic murmur",
        "Aortic stenosis: systolic ejection murmur → carotid; syncope + angina + dyspnoea",
        "Infective endocarditis: Duke criteria (2 major OR 1 major + 3 minor); Osler nodes (painful)",
        "Pericardial effusion: Beck's triad — muffled sounds, ↓BP, JVP↑; pulsus paradoxus",
        "Atrial fibrillation: irregularly irregular; anticoagulate if CHA2DS2-VASc ≥ 2",
      ]},
      { h: "Endocrinology + Neurology", items: [
        "DM2 diagnosis: FBG ≥ 126 mg/dL (× 2); OGTT 2hr ≥ 200; HbA1c ≥ 6.5%",
        "DKA: anion-gap metabolic acidosis; Kussmaul breathing; fruity breath; insulin + IVF",
        "HHS: extreme hyperglycemia (> 600); no acidosis; older T2DM; dehydration dominant",
        "Hypothyroidism: cold intolerance, constipation, bradycardia; ↑TSH, ↓T4",
        "Hyperthyroidism: heat intolerance, weight loss, AF; ↓TSH, ↑T4",
        "Cushing's syndrome: buffalo hump, moon face, striae, hypertension; ↑cortisol",
        "Addison's disease: bronze skin, hypotension, hyperkalemia; ↓cortisol + ↓aldosterone",
        "Parkinson's: dopamine deficiency (substantia nigra); tremor + rigidity + bradykinesia",
        "Meningitis: bacterial → urgent LP; N. meningitidis: petechiae; treat ceftriaxone",
        "Stroke: FAST; ischemic (85%) → tPA within 4.5 hrs; hemorrhagic → BP control",
      ]},
      { h: "Infectious Disease + Rheumatology", items: [
        "Malaria diagnosis: thick blood smear (sensitivity); PfHRP2 rapid test for P. falciparum",
        "P. falciparum treatment: artemisinin-based combination therapy (ACT)",
        "Typhoid: blood culture (1st week); Widal (2nd week); bone marrow (gold standard)",
        "HIV: HAART start all patients regardless of CD4; TDF + 3TC + DTG (WHO preferred)",
        "Dengue warning signs: abdominal pain, persistent vomiting, rapid ↓platelets, bleeding",
        "SLE: ANA (sensitive); anti-dsDNA (specific + disease activity); anti-Sm (specific)",
        "Rheumatoid arthritis: anti-CCP (most specific); RF; treat: MTX first line DMARD",
        "Gout: uric acid crystals; negatively birefringent; treat acute with colchicine/NSAIDs",
        "Ankylosing spondylitis: HLA-B27; bamboo spine; sacroiliitis; NSAIDs first",
        "Reactive arthritis: Reiter's — urethritis + arthritis + uveitis; post-infection",
      ]},
    ]
  },

  {
    title: "GENERAL SURGERY", marks: 32, color: "196F3D", accent: "D5F5E3",
    cols: [
      { h: "GI Surgery", items: [
        "Appendicitis: McBurney's point; Rovsing's sign; Psoas sign; Alvarado score ≥ 7",
        "Perforated peptic ulcer: pneumoperitoneum (free air under diaphragm); rigid abdomen",
        "Intestinal obstruction: distended loops; ladder pattern; treat with decompression",
        "Achalasia: LES relaxation failure; rat-tail appearance on barium swallow",
        "Hirschsprung: absent myenteric plexus; rectal biopsy confirms; contrast enema: funnel",
        "Colorectal cancer: sigmoid MC site; Duke's staging; CEA marker; colonoscopy",
        "Hernia: indirect inguinal MC; direct through Hesselbach's; femoral: elderly women",
        "Hemorrhoids: 3, 7, 11 o'clock positions; internal (above dentate) = painless bleeding",
        "Fistula-in-ano: Goodsall's rule — posterior fistula → posterior midline; anterior → radial",
      ]},
      { h: "Breast + Thyroid", items: [
        "Breast lump: triple assessment — clinical + imaging + tissue (FNAC/biopsy)",
        "Fibroadenoma: MC in young women (< 30); mobile, firm, benign; reassurance + follow-up",
        "Breast cancer: MC invasive = invasive ductal carcinoma; BRCA1/2 mutations",
        "Inflammatory breast cancer: peau d'orange skin; erythema; poor prognosis",
        "Gynecomastia: liver disease, estrogen excess, drugs (spironolactone, digoxin, cimetidine)",
        "Thyroid nodule: cold nodule on scan → malignant risk; FNAC = gold standard",
        "Papillary thyroid CA: MC type; psammoma bodies; lymph node metastasis",
        "Medullary thyroid CA: calcitonin marker; associated with MEN 2A/2B",
        "Anaplastic thyroid CA: worst prognosis; rapid local invasion; elderly patients",
      ]},
      { h: "Trauma + Shock", items: [
        "Shock classification: Class I (< 15% volume loss) → Class IV (> 40%)",
        "ATLS primary survey: ABCDE — Airway, Breathing, Circulation, Disability, Exposure",
        "Tension pneumothorax: tracheal deviation away; absent breath sounds; treat needle decompression",
        "Cardiac tamponade: Beck's triad + pulsus paradoxus; pericardiocentesis",
        "Burns: Wallace rule of nines; 9% each arm; 18% each leg/front/back torso; 9% head",
        "Parkland formula: 4 mL/kg/% TBSA burn; first half in 8 hrs, second in 16 hrs",
        "Deep burns: insensate; charred/leathery; grafting needed",
        "Compartment syndrome: pain with passive stretch; treat with fasciotomy urgently",
        "Wound healing: primary (clean sutured); secondary (granulation); tertiary (delayed closure)",
      ]},
    ]
  },

  {
    title: "OBG", marks: 30, color: "7D3C98", accent: "F5EEF8",
    cols: [
      { h: "Obstetrics High-Yield", items: [
        "Gestational age: Naegele's rule = LMP + 9 months + 7 days",
        "Normal fundal height: at umbilicus = 20 weeks; at xiphisternum = 36 weeks",
        "First trimester screening: PAPP-A + β-hCG + NT scan (11–13+6 weeks)",
        "Placenta previa: painless PV bleeding; avoid PV examination; ultrasound diagnosis",
        "Abruptio placentae: painful PV bleeding; woody hard uterus; DIC risk",
        "Pre-eclampsia: BP ≥ 140/90 + proteinuria after 20 weeks; MgSO4 for seizure prevention",
        "Eclampsia: MgSO4 is treatment of choice (Pritchard regimen); control BP",
        "Post-partum hemorrhage: MC cause = uterine atony; oxytocin is first line (AMTSL)",
        "Shoulder dystocia: turtle sign; McRobert's maneuver (hyperflexion of maternal thighs)",
        "Cord presentation/prolapse: urgent delivery; knee-chest position to relieve pressure",
      ]},
      { h: "Normal Labour + Puerperium", items: [
        "Stages of labour: 1st = onset to full dilatation; 2nd = delivery of baby; 3rd = placenta",
        "Active phase labour: cervix dilates ≥ 1 cm/hour (1st stage active)",
        "Partogram: alert line + action line (4 hr right shift); plot cervical dilatation",
        "Episiotomy: mediolateral preferred (avoids sphincter); sutured in 3 layers",
        "AMTSL: oxytocin 10 IU IM within 1 min of delivery; controlled cord traction",
        "Lochial discharge: lochia rubra (1–3 days) → serosa → alba (week 3+)",
        "Involution: uterus returns to pelvic organ by day 10–14",
        "Breastfeeding: exclusive for 6 months (WHO); benefits immunity + LAM contraception",
        "Puerperal fever: temp > 38°C on 2 of first 10 days (excluding first 24 hrs)",
        "Mastitis: S. aureus; unilateral; treat with cloxacillin; do NOT stop breastfeeding",
      ]},
      { h: "Gynaecology + Contraception", items: [
        "Fibroids: leiomyoma; menorrhagia MC symptom; GnRH analogue pre-op shrinkage",
        "Ectopic pregnancy: ampulla MC site; β-hCG + transvaginal US; methotrexate if < 3.5 cm",
        "PCOS: oligomenorrhea + hyperandrogenism + polycystic ovaries (Rotterdam criteria 2/3)",
        "Endometriosis: chocolate cysts; CA-125 elevated; chocolate-colored fluid on laparoscopy",
        "Cervical cancer: MC = squamous cell; HPV 16/18; CIN I–III → invasive",
        "Ovarian cancer: MC = epithelial; CA-125; worst prognosis; mostly diagnosed late (III/IV)",
        "OCP: inhibit LH surge → prevents ovulation; monophasic most common",
        "Cu-IUD: most effective emergency contraception (up to 5 days); also long-term",
        "DMPA (Depo-Provera): 3-monthly injection; MC SE = menstrual irregularities",
        "Permanent sterilization: Pomeroy (tubal ligation) vs Essure (hysteroscopic)",
      ]},
    ]
  },

  {
    title: "COMMUNITY MEDICINE", marks: 30, color: "A04000", accent: "FDEBD0",
    cols: [
      { h: "National Immunization Schedule", items: [
        "Birth: BCG + OPV-0 + Hep B-1",
        "6 weeks: OPV-1 + IPV-1 + Penta-1 (DPT+HepB+Hib) + Rota-1 + PCV-1",
        "10 weeks: OPV-2 + IPV-2 + Penta-2 + Rota-2 + PCV-2",
        "14 weeks: OPV-3 + IPV-3 + Penta-3 + Rota-3 + PCV-3",
        "9 months: MR-1 + JE-1 (endemic areas) + Vit A-1",
        "16–24 months: DPT booster-1 + OPV booster + MR-2 + JE-2 + PCV booster + Vit A-2",
        "5–6 years: DPT booster-2",
        "10 & 16 years: Td (tetanus + diphtheria)",
        "Pregnant women: Td × 2 doses (4 wks apart) if unvaccinated; 1 booster if vaccinated",
        "Cold chain: 2–8°C for most vaccines; OPV at –15 to –25°C",
      ]},
      { h: "Epidemiology + Biostatistics", items: [
        "Incidence: new cases per population per time",
        "Prevalence = incidence × duration; more useful for chronic disease planning",
        "Sensitivity = TP/(TP+FN); ability to detect disease; high sensitivity = good screening",
        "Specificity = TN/(TN+FP); rules OUT disease; high specificity = good confirmation",
        "PPV: probability disease is present given positive test; affected by prevalence",
        "Odds ratio: case-control studies; Relative Risk: cohort studies",
        "Attributable risk = incidence (exposed) − incidence (unexposed)",
        "RCT: gold standard for causation; randomization controls confounders",
        "Bias types: selection, information (recall, interviewer), confounding",
        "NNT = 1/ARR (absolute risk reduction); smaller NNT = more effective treatment",
      ]},
      { h: "National Health Programs + Nutrition", items: [
        "RNTCP/NTEP: DOTS strategy; 6-month regimen for new PTB; TrueNat/CBNAAT diagnosis",
        "NVBDCP: malaria + dengue + filariasis + kala-azar; DDT spraying in endemic areas",
        "NACP: HIV/AIDS; ICTC for testing; ART centers; PPTCT for pregnant women",
        "NPCDCS: NCD screening — diabetes, hypertension, cancers at PHC level",
        "Protein energy malnutrition: Kwashiorkor = edema + adequate calories but ↓protein",
        "Marasmus: overall caloric deprivation; wasted, no edema, alert child",
        "MUAC (mid-upper arm circumference): < 11.5 cm = SAM; 11.5–12.5 = MAM",
        "SAM treatment: F-75 (stabilization) → F-100 (rehabilitation); 10-step WHO protocol",
        "Iodine deficiency: cretinism + goiter; iodize salt (30 ppm) as control measure",
        "Vit A supplementation: 6 months–5 years; 1 lakh IU at 9 months with MR vaccine",
      ]},
    ]
  },

  {
    title: "PAEDIATRICS", marks: 15, color: "1F618D", accent: "D6EAF8",
    cols: [
      { h: "Developmental Milestones", items: [
        "Social smile: 6 weeks (earliest milestone)",
        "Neck holding: 3 months; no head lag by 4 months",
        "Rolls over: 5 months; sits without support: 6–7 months",
        "Stands with support: 9 months; walks independently: 12–15 months",
        "Pincer grasp: 9 months; transfers objects hand-to-hand: 6 months",
        "Single words with meaning: 12 months; 2–3 word phrases: 18–24 months",
        "Names: 2 months (cooing); babbling: 6 months",
        "Tricycle riding: 3 years; alternating steps on stairs: 3 years; hopping: 4 years",
        "Developmental red flags: no social smile by 3 months; no words by 18 months",
      ]},
      { h: "Neonatology", items: [
        "Apgar score: at 1 and 5 min; 5 criteria (0–2 each); ≥ 7 = normal",
        "Apgar: Appearance (color), Pulse, Grimace (reflex), Activity (tone), Respiration",
        "RDS (HMD): surfactant deficiency; premature < 34 weeks; ground-glass opacity on CXR",
        "Surfactant: dipalmitoyl phosphatidylcholine (DPPC); lecithin:sphingomyelin > 2 = maturity",
        "Neonatal jaundice: physiological → appears day 2–3, peaks day 4–5, clears by day 7",
        "Pathological jaundice: appears within 24 hrs OR total bilirubin > 12 mg/dL (term)",
        "Kernicterus: unconjugated bilirubin deposits in basal ganglia; treat with phototherapy/exchange",
        "Sepsis neonatorum: early (< 72 hrs) = GBS/E. coli; late (> 72 hrs) = Staph/Klebsiella",
        "PDA: continuous machine-like murmur; indomethacin closes it in premature infants",
      ]},
      { h: "Paediatric Diseases", items: [
        "Measles: maculopapular rash day 3–4; Koplik's spots on buccal mucosa (pathognomonic)",
        "Chickenpox: vesicular rash — all stages simultaneously (centripetal distribution)",
        "Whooping cough: catarrhal (1–2 wk) → paroxysmal (inspiratory whoop) → convalescent",
        "Meningococcal meningitis: petechial/purpuric rash; treat ceftriaxone urgently",
        "Kawasaki disease: fever > 5 days + 4/5 criteria; IVIG + aspirin; coronary aneurysm risk",
        "Intussusception: currant-jelly stool; MC 5–9 months; air/barium enema (diagnostic+RX)",
        "Pyloric stenosis: projectile non-bilious vomiting; 4–6 weeks male; olive-shaped mass",
        "Down syndrome: trisomy 21; epicanthic folds, simian crease, Brushfield spots; AV canal defect",
        "Febrile seizure: 6 months–6 years; treat acute with rectal diazepam; reassure parents",
        "Nephrotic syndrome: triad — heavy proteinuria + hypoalbuminemia + edema; minimal change MC",
      ]},
    ]
  },

  {
    title: "ENT", marks: 15, color: "148F77", accent: "D1F2EB",
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      { h: "Ear", items: [
        "Otitis media: AOM — bulging TM; penicillin; MC organism: S. pneumoniae > H. influenzae",
        "CSOM: safe type (tubotympanic, central perforation); unsafe (attico-antral, cholesteatoma)",
        "Cholesteatoma: keratinizing epithelium in middle ear; destroys bone; epitympanic retraction",
        "Otosclerosis: fixation of stapes footplate; conductive hearing loss; Schwartze sign (flamingo pink)",
        "Meniere's disease: endolymphatic hydrops; fluctuating SNHL + tinnitus + vertigo + aural fullness",
        "BPPV: canalith (otolith) displacement; Dix-Hallpike test; treat with Epley maneuver",
        "Acoustic neuroma: CN VIII schwannoma; unilateral SNHL + tinnitus; cerebellopontine angle",
        "Rinne's test: positive (AC > BC) = normal/SNHL; negative (BC > AC) = conductive loss",
        "Weber's test: lateralizes to affected ear in conductive loss; better ear in SNHL",
      ]},
      { h: "Nose + Throat", items: [
        "Epistaxis: Little's area (Kiesselbach's plexus) — anterior nose MC site in children",
        "Deviated nasal septum: DNS; septal haematoma → perichondritis risk; drain urgently",
        "Allergic rhinitis: pale bluish turbinates; eosinophils in smear; treat: antihistamine + steroid spray",
        "Sinusitis: maxillary MC sinus affected; pain on bending forward; anterior rhinoscopy",
        "Angiofibroma: nasopharynx; adolescent males; epistaxis + nasal obstruction; highly vascular",
        "Tonsillitis: peritonsillar abscess (quinsy) = complication; uvula displaced to contralateral side",
        "Adenoids: mouth breathing + snoring in children; postnasal drip; X-ray lateral neck",
        "Carcinoma larynx: glottic (best prognosis — early hoarseness); supraglottic: dysphagia",
        "Foreign body: right bronchus MC (more vertical); sudden cough + unilateral wheeze in child",
      ]},
      { h: "Hearing Loss Types + Quick Facts", items: [
        "Conductive: CHL — problem in outer/middle ear; AC > BC; Weber → affected ear",
        "Sensorineural: SNHL — cochlea/CN VIII; BC = AC (both reduced); Weber → better ear",
        "Mixed: CHL + SNHL; Rinne negative; Weber variable",
        "Audiogram: > 25 dB loss = hearing impairment",
        "Otoacoustic emissions (OAE): newborn hearing screening tool",
        "BERA (brainstem evoked response): objective; assesses retrocochlear pathology",
        "Presbycusis: age-related SNHL; high-frequency loss first; bilateral symmetric",
        "Noise-induced: 4000 Hz notch on audiogram (C5 dip); occupation-related",
        "Ototoxic drugs: aminoglycosides, cisplatin, loop diuretics (furosemide), quinine",
      ]},
    ]
  },

  {
    title: "OPHTHALMOLOGY", marks: 15, color: "1C6EA4", accent: "D6EAF8",
    cols: [
      { h: "Glaucoma + Cataract", items: [
        "Primary open-angle glaucoma: MC type; painless; insidious; IOP > 21 mmHg; cupping",
        "POAG treatment: prostaglandin analogues (latanoprost) first line; β-blocker (timolol)",
        "Acute angle-closure glaucoma: painful red eye; mid-dilated fixed pupil; halos; nausea",
        "AACG treatment: urgent — acetazolamide IV + pilocarpine + timolol + laser iridotomy",
        "Normal IOP: 10–21 mmHg; Goldmann applanation tonometry = gold standard",
        "Cataract: MC cause of treatable blindness worldwide; nuclear sclerosis = MC type",
        "Congenital cataract: leukocoria (white pupil); treat < 6 weeks to prevent amblyopia",
        "Post-cataract surgery: posterior capsule opacification → Nd:YAG laser capsulotomy",
        "Cataract surgery: PHACO (phacoemulsification) + IOL implant = gold standard",
      ]},
      { h: "Retina + Uvea", items: [
        "Diabetic retinopathy: non-proliferative (microaneurysms) → proliferative (new vessels)",
        "Macular degeneration (AMD): dry (drusen) vs wet (choroidal neovascularization); anti-VEGF",
        "Retinal detachment: photopsia + floaters + curtain defect; rhegmatogenous MC type",
        "CRVO: disc swelling, flame hemorrhages, dilated veins ('blood and thunder' fundus)",
        "CRAO: sudden painless vision loss; cherry-red spot at macula; pale retina",
        "Uveitis: anterior (iritis) — ciliary flush + keratic precipitates + flare + cells in AC",
        "Posterior uveitis: floaters + blurred vision; toxoplasma MC cause worldwide",
        "Sympathetic ophthalmia: penetrating trauma → bilateral panuveitis (autoimmune)",
        "Retinoblastoma: MC pediatric intraocular tumor; leukocoria; 'cat's eye reflex'",
      ]},
      { h: "Ocular Conditions Quick-Facts", items: [
        "Corneal ulcer: Mooren's ulcer (autoimmune); bacterial = hypopyon; viral (HSV) = dendritic",
        "Trachoma: Chlamydia trachomatis; MC cause of preventable blindness; follicles on everted lid",
        "Pterygium: fibrovascular growth over nasal cornea; excision + conjunctival auto-graft",
        "Episcleritis: sectoral redness; benign self-limiting; treated with topical NSAIDs",
        "Scleritis: deeper, more painful; associated with RA/SLE; treat systemic steroids",
        "Horner's syndrome: ptosis + miosis + anhidrosis (enophthalmos); cervical sympathetic chain",
        "CN III palsy: complete ptosis + 'down and out' eye + dilated unreactive pupil",
        "CN VI palsy: medial deviation (convergent squint); lateral rectus palsy",
        "Accommodation reflex: convergence + pupil constriction + lens thickening (CN III)",
      ]},
    ]
  },

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      { h: "Mood + Psychotic Disorders", items: [
        "Major depressive disorder: SIGECAPS + > 2 weeks; treat SSRIs (fluoxetine) first line",
        "Bipolar I: mania + depression; treat mania with lithium/valproate + antipsychotic",
        "Bipolar II: hypomania + depression; lithium or lamotrigine",
        "Schizophrenia: positive (delusions, hallucinations) + negative (flat affect, alogia, avolition)",
        "Schizophrenia Rx: atypical antipsychotics (risperidone, olanzapine, clozapine for refractory)",
        "Clozapine: only effective in treatment-resistant; risk = agranulocytosis (CBC weekly)",
        "NMS (neuroleptic malignant syndrome): fever + rigidity + ↑CPK; stop antipsychotic; dantrolene",
        "Serotonin syndrome: hyperthermia + clonus + diarrhea; precipitated by multiple serotonergic drugs",
      ]},
      { h: "Anxiety + Other Disorders", items: [
        "GAD: excessive worry > 6 months; SSRIs or SNRIs; buspirone",
        "Panic disorder: unexpected panic attacks; fear of attack; SSRIs + CBT",
        "OCD: ego-dystonic obsessions + compulsions; SSRIs (highest doses); clomipramine",
        "PTSD: traumatic event → re-experiencing, avoidance, hyperarousal; SSRIs + trauma-CBT",
        "Conversion disorder: neurological sx without organic cause; la belle indifference",
        "ADHD: inattention + hyperactivity > 6 months before 12 years; methylphenidate",
        "Autism spectrum: impaired social communication + repetitive behaviors",
        "Anorexia nervosa: BMI < 17.5; restrict caloric intake; lanugo hair, amenorrhea",
        "Bulimia: binge + purge; normal/overweight; parotid enlargement; treat SSRIs + CBT",
      ]},
      { h: "Substance Use + ECT", items: [
        "Alcohol dependence: CAGE questionnaire; delirium tremens (24–72 hrs after cessation)",
        "DTs: seizures + autonomic instability + hallucinations; treat IV benzodiazepines",
        "Opioid withdrawal: yawning + lacrimation + diarrhea + piloerection; treat methadone",
        "Opioid OD: miosis + coma + respiratory depression; IV naloxone",
        "Benzodiazepine withdrawal: seizures; taper gradually; IV diazepam",
        "ECT: absolute indication = severe depression with suicidal risk / psychotic depression / catatonia",
        "ECT mechanism: seizure induced; bilateral temporal placement most effective",
        "IQ ranges: Mild MR = 50–70; Moderate = 35–50; Severe = 20–35; Profound < 20",
      ]},
    ]
  },

  {
    title: "DERMATOLOGY + STD", marks: 5, color: "78281F", accent: "FADBD8",
    cols: [
      { h: "Common Dermatoses", items: [
        "Psoriasis: silvery-white scales on extensor surfaces; Auspitz sign; Koebner phenomenon",
        "Lichen planus: purple, pruritic, polygonal plaques; Wickham's striae; buccal mucosa",
        "Pityriasis rosea: herald patch → Christmas-tree pattern; self-limiting (6–8 weeks)",
        "Pemphigus vulgaris: flaccid bullae; Nikolsky's sign positive; acantholysis; autoimmune",
        "Bullous pemphigoid: tense bullae; Nikolsky's negative; elderly; IgG at BMZ",
        "Leprosy: hypopigmented anaesthetic patches; thickened nerves; Mycobacterium leprae",
        "Paucibacillary leprosy: ≤ 5 lesions; dapsone + rifampicin × 6 months",
        "Multibacillary leprosy: > 5 lesions; dapsone + rifampicin + clofazimine × 12 months",
        "Scabies: nocturnal pruritus; web spaces; permethrin 5% treatment; treat all contacts",
      ]},
      { h: "Sexually Transmitted Infections", items: [
        "Syphilis: T. pallidum; primary = painless chancre; secondary = rash palms+soles",
        "VDRL/RPR: non-specific (screening); TPHA/FTA-ABS: specific (confirmation)",
        "Gonorrhoea: N. gonorrhoeae; urethral discharge; Gram-negative diplococci intracellular",
        "Chlamydia: C. trachomatis (D–K); MC bacterial STI; treat doxycycline or azithromycin",
        "Genital herpes: HSV-2 (MC); multiple painful vesicles; recurrent; acyclovir treatment",
        "Chancroid: H. ducreyi; painful ulcer + painful inguinal LAP (bubo); soft chancre",
        "LGV: C. trachomatis (L1–L3); groove sign; buboes + fistulae + rectal strictures",
        "Condyloma accuminata: HPV 6,11 (low risk); cauliflower-like; podophyllin / cryotherapy",
        "HIV transmission: highest risk unprotected anal receptive intercourse",
      ]},
      { h: "Fungal + Miscellaneous", items: [
        "Tinea capitis: Microsporum (ectothrix, fluorescent) vs Trichophyton (endothrix)",
        "Tinea versicolor: M. furfur (Malassezia); hypo/hyperpigmented macules; 'spaghetti and meatballs'",
        "Tinea pedis: athlete's foot; web-space maceration; treat topical antifungal",
        "Dermatophyte treatment: topical clotrimazole (limited); oral terbinafine (extensive/nail)",
        "Onychomycosis: nail involvement; terbinafine 3 months (finger) / 6 months (toe)",
        "Atopic dermatitis: itch + itch → scratch cycle; raised IgE; treat: emollients + topical steroids",
        "Urticaria: wheal + flare; mast cell histamine; acute = allergic; chronic = autoimmune",
        "Vitiligo: autoimmune melanocyte destruction; milky-white macules; Koebner positive",
        "Alopecia areata: patchy non-scarring hair loss; exclamation mark hairs",
      ]},
    ]
  },

  {
    title: "ORTHOPAEDICS", marks: 5, color: "1E8449", accent: "D5F5E3",
    cols: [
      { h: "Fractures — Classification + Management", items: [
        "Colles' fracture: distal radius; fall on outstretched hand (FOOSH); dinner fork deformity",
        "Smith's fracture: reverse Colles' (volar angulation); 'garden spade' deformity",
        "Scaphoid fracture: anatomical snuffbox tenderness; AVN risk; X-ray often normal initially",
        "Monteggia: ulna fracture + radial head dislocation",
        "Galeazzi: radius fracture + distal radioulnar joint dislocation",
        "Hip fracture: neck of femur → intracapsular (AVN risk); intertrochanteric → extracapsular",
        "Garden classification (NOF fractures): I–II (undisplaced) vs III–IV (displaced → hemi/THR)",
        "Colle's fracture: Proximal and dorsal displacement of distal radius (FMGE classic Q)",
        "Compartment syndrome: 5 P's — Pain, Pallor, Paraesthesia, Paralysis, Pulselessness",
      ]},
      { h: "Bone + Joint Infections", items: [
        "Osteomyelitis: MC = Staphylococcus aureus (all ages); Salmonella in sickle cell",
        "Acute osteomyelitis: metaphysis (rich blood supply); local tenderness + fever",
        "Brodie's abscess: chronic low-grade osteomyelitis; sclerotic margin cavity",
        "Septic arthritis: MC = S. aureus; warm swollen joint; urgent joint aspiration + IV antibiotics",
        "TB of spine (Pott's disease): vertebral collapse → kyphosis; psoas abscess (cold abscess)",
        "Osteoarthritis: joint space narrowing + osteophytes + subchondral sclerosis",
        "Rheumatoid arthritis: synovial proliferation; joint erosions; anti-CCP most specific",
        "CPPD (pseudogout): calcium pyrophosphate crystals; positively birefringent; knee MC",
        "Gout: negatively birefringent crystals; 1st MTP (podagra) MC; urate-lowering therapy",
      ]},
      { h: "Congenital + Metabolic Bone", items: [
        "Developmental dysplasia of hip (DDH): Ortolani (reduce) + Barlow (dislocate) tests at birth",
        "CTEV (club foot): forefoot adduction + hindfoot equinovarus; Ponseti method (serial casting)",
        "Perthes disease: AVN femoral head in children 4–8 years; limping + limited internal rotation",
        "SCFE (slipped capital femoral epiphysis): overweight adolescent; 'ice cream falling off cone'",
        "Rickets: Vit D deficiency; bowing of legs; rachitic rosary; Looser zones on X-ray",
        "Osteoporosis: T-score ≤ –2.5; fragility fractures; bisphosphonates first line treatment",
        "Osteosarcoma: MC primary malignant bone tumor; distal femur/proximal tibia; sunburst + Codman's triangle",
        "Ewing's sarcoma: diaphysis; children; onion-peel periosteal reaction; t(11;22) translocation",
        "Chondrosarcoma: adults; pelvis/proximal femur; popcorn calcification; poor prognosis if dedifferentiated",
      ]},
    ]
  },

  {
    title: "ANAESTHESIA", marks: 5, color: "21618C", accent: "D6EAF8",
    cols: [
      { h: "Pharmacology of Anaesthesia", items: [
        "Induction agents: propofol (most common), thiopentone (STP), ketamine (dissociative)",
        "Ketamine: NMDA antagonist; bronchodilator; raises ICP + IOP; 'emergence reactions'",
        "Halothane: volatile agent; hepatotoxic (halothane hepatitis); malignant hyperthermia trigger",
        "Nitrous oxide: weak analgesic + anesthetic; 'laughing gas'; expands air pockets; avoid in pneumothorax",
        "Succinylcholine: depolarizing NMJ blocker; fasciculations → paralysis; pseudocholinesterase metabolises",
        "Rocuronium: non-depolarizing; fastest onset; reversed by sugammadex",
        "Fentanyl: potent opioid; short acting; good for intubation; 100× stronger than morphine",
        "Neostigmine: reverses non-depolarizing blockers; give with atropine to prevent bradycardia",
        "Malignant hyperthermia: succinylcholine + halothane trigger; ↑temp + rigidity + ↑CPK; treat dantrolene",
      ]},
      { h: "Regional Anaesthesia + Monitoring", items: [
        "Spinal anaesthesia: subarachnoid space (< L1–L2 in adults); bupivacaine heavy most used",
        "Epidural: epidural space; catheter technique; level controlled by volume; used in labour",
        "Brachial plexus block: interscalene (shoulder); supraclavicular (arm); axillary (hand)",
        "Local anaesthetics: lignocaine (lidocaine) MC used; bupivacaine for longer duration",
        "LA toxicity: perioral tingling → seizures → cardiovascular collapse; treat with Intralipid 20%",
        "ASA classification: I (healthy) → V (moribund); 'E' suffix for emergency",
        "Pre-operative fasting: solids 6 hrs; clear fluids 2 hrs (2-4-6 rule: 2 hrs clear, 4 hrs breast milk, 6 hrs solids)",
        "Capnography: end-tidal CO2; best method to confirm ET tube placement; normal 35–45 mmHg",
        "SpO2 probe: pulse oximetry; unreliable in CO poisoning; carboxyhemoglobin shows falsely normal",
      ]},
      { h: "Airway + ICU Essentials", items: [
        "Cormack-Lehane: grade I (entire glottis visible) → grade IV (no glottic structures)",
        "Difficult airway predictors: LEMON — Look, Evaluate (3-3-2 rule), Mallampati, Obstruction, Neck mobility",
        "Mallampati I: full tonsillar pillars + uvula; IV: soft palate not visible → difficult intubation",
        "Cricothyroid membrane: emergency surgical airway landmark; between thyroid and cricoid",
        "Ventilator settings: TV 6–8 mL/kg (protective); PEEP 5–8 cmH2O; plateau pressure < 30",
        "ARDS: Berlin definition: PaO2/FiO2 < 300; bilateral infiltrates; not cardiogenic",
        "Septic shock: MAP < 65 + vasopressor need + lactate > 2 despite fluid; 30 mL/kg crystalloid bolus",
        "CVP: normal 2–8 mmHg; guides fluid therapy in critically ill",
        "Ondansetron: 5-HT3 antagonist; best post-operative antiemetic; doesn't cause sedation",
      ]},
    ]
  },

  {
    title: "RADIODIAGNOSIS", marks: 5, color: "1B4F72", accent: "D6EAF8",
    cols: [
      { h: "Chest X-Ray Interpretation", items: [
        "Cardiomegaly: CTR > 0.5 (PA view); assess borders: right = RA + SVC; left = aortic knuckle + PA + LV",
        "Pulmonary oedema: Kerley B lines (interstitial), bat-wing opacity (alveolar), cephalization",
        "Pleural effusion: meniscus sign; costophrenic angle blunting (> 200 mL); blunts diaphragm",
        "Tension pneumothorax: tracheal deviation away, absent vascular markings, mediastinal shift",
        "Consolidation: air-bronchogram; lobar (bacteria) vs. patchy (viral/atypical)",
        "Cavitation: TB (upper lobe), lung abscess, carcinoma, Wegener's",
        "Miliary TB: 1–2 mm millet-seed nodules throughout lung fields",
        "Sarcoidosis: bilateral hilar lymphadenopathy (BHL) + parenchymal nodules",
        "Coin lesion: solitary pulmonary nodule; popcorn Ca2+ = hamartoma; benign",
      ]},
      { h: "Abdomen + Bones", items: [
        "Free air under diaphragm: erect CXR; indicates visceral perforation → emergency surgery",
        "Small bowel obstruction: multiple air-fluid levels; dilated loops (> 3 cm); valvulae conniventes",
        "Large bowel obstruction: haustra; peripheral distribution; caecum > 9 cm → risk of perforation",
        "Volvulus: sigmoid volvulus → coffee-bean sign; caecal volvulus → kidney-shaped gas shadow",
        "Renal calculi: 90% radio-opaque on plain X-ray; IVP/CT KUB for diagnosis",
        "Paget's disease of bone: bone enlargement + mixed sclerotic-lytic; 'cotton wool' skull",
        "Osteosarcoma: Codman's triangle + sunburst periosteal reaction; distal femur",
        "Rickets: widened growth plate, cupping/fraying of metaphysis, Looser's zones",
        "Ankylosing spondylitis: 'bamboo spine'; sacroiliac joint erosions; syndesmophytes",
      ]},
      { h: "CT/MRI/USG Essentials", items: [
        "CT Head — hyperdense = acute bleed (SAH, SDH, extradural); hypodense = oedema/infarct",
        "Extradural hematoma: biconvex (lenticular) hyperdense lesion; middle meningeal artery",
        "Subdural hematoma: crescentic; crosses suture lines; bridging veins; elderly/alcoholics",
        "SAH: hyperdensity in subarachnoid spaces / cisterns; LP → xanthochromia (12 hrs–2 wks)",
        "USG liver: fatty liver = hyperechoic; cirrhosis = nodular surface + ↓liver size + ascites",
        "USG abdomen: best first-line for biliary, renal, gynae pathology; real-time + no radiation",
        "MRI: superior for brain/spinal cord/soft tissue; no ionizing radiation; gadolinium contrast",
        "Contrast nephropathy: risk with iodinated contrast; prevent with hydration + N-acetylcysteine",
        "Radiation doses: CXR ~0.02 mSv; CT chest ~7 mSv; background radiation ~2.4 mSv/yr",
      ]},
    ]
  },
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    const tw = t.length * 0.085 + 0.4;
    s.addShape(pres.ShapeType.roundRect, { x: tx, y: ty, w: tw, h: 0.34,
      fill: { color: "1B3A5C" }, line: { color: "2C6B8A", width: 1 }, rectRadius: 0.1 });
    s.addText(t, { x: tx, y: ty, w: tw, h: 0.34,
      fontSize: 9, color: "7AADCC", align: "center", valign: "middle", margin: 0 });
    tx += tw + 0.12;
  });

  s.addText("Orris AI  •  FMGE Prep 2026  •  Based on PYQ analysis + standard textbooks", {
    x: 0.6, y: 7.1, w: 12, h: 0.3,
    fontSize: 9, color: "445566", margin: 0
  });
}

// ── Generate all subject slides ───────────────────────────────────────────────
SUBJECTS.forEach(makeCheatSheet);

// ── Write ─────────────────────────────────────────────────────────────────────
const outPath = "/home/daytona/workspace/fmge-cheatsheets/FMGE_HighYield_CheatSheets.pptx";
pres.writeFile({ fileName: outPath })
  .then(() => console.log("DONE:", outPath))
  .catch(e => { console.error("ERROR:", e); process.exit(1); });