Give any one research paper

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artificial intelligence medicine

Here is one recent research paper:

Artificial Intelligence in Mental Health Care: A Systematic Review of Diagnosis, Monitoring, and Intervention Applications

Authors: Cruz-Gonzalez P, He AW, Lam EP
Journal: Psychological Medicine
Published: February 6, 2025
PMID: 39911020
Evidence Tier: Systematic Review (highest level of evidence)

What it covers: This systematic review examines how AI is being applied across three key areas of mental health care:

Diagnosis - using AI models to detect conditions like depression, anxiety, schizophrenia, etc.
Monitoring - tracking patient symptoms and mental health status over time using sensors, apps, or wearables
Intervention - AI-driven tools (chatbots, digital therapeutics) that actively support or treat patients

This is a highly relevant topic given the global mental health burden and the rapid growth of AI-powered clinical tools. If you'd like a summary of its findings, want to explore a different topic, or need the full citation in APA/BibTeX format, just ask!

Find more recent papers on AI in mental health diagnosis

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"artificial intelligence"[MeSH Terms] AND "mental disorders"[MeSH Terms] AND diagnosis

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AI artificial intelligence mental health diagnosis research papers 2025 2026

Here are 9 recent peer-reviewed papers on AI in mental health diagnosis (all from 2024-2025, all Systematic Reviews unless noted):

Systematic Reviews

#	Title	Authors	Journal	Date	PMID
1	Use of generative AI in psychiatry and mental health care	Kolding S et al.	Acta Neuropsychiatr	Nov 2024	39523628
2	Effectiveness of AI in detecting and managing depressive disorders	Park Y et al.	J Affect Disord	Sep 2024	38889858
3	Recent developments in omics studies and AI in depression and suicide	Wang Q, Dwivedi Y	Transl Psychiatry	Aug 2025	40790016
4	Application of AI in the field of mental health	Dehbozorgi R et al.	BMC Psychiatry	Feb 2025	39953464
5	AI in mental health care: diagnosis, monitoring, and intervention	Cruz-Gonzalez P et al.	Psychol Med	Feb 2025	39911020
6	Neuroimaging and machine learning in eating disorders	Monaco F et al.	Eat Weight Disord	Jun 2025	40450619
7	Ethical implications of generative AI in mental health	Wang X et al.	JMIR Ment Health	Jun 2025	40577783
8	Evaluating generative AI in mental health: capabilities and limitations	Wang L et al.	JMIR Ment Health	May 2025	40373033

Randomized Controlled Trial

#	Title	Authors	Journal	Date	PMID
9	AI in psychotherapy: development of intelligent therapeutic systems	Spytska L	BMC Psychol	Feb 2025	40022267

Key themes across these papers:

Generative AI (LLMs/ChatGPT) is increasingly being studied for psychiatric assessment and therapy support
Depression detection is the most studied use case, using NLP, social media data, and EHR analysis
Neuroimaging + ML is being applied to eating disorders, schizophrenia, and autism
Ethical concerns (privacy, bias, explainability) are a growing focus in 2025 literature

Would you like me to fetch the full abstract of any specific paper, find related studies, or export citations in APA/BibTeX format?

Give some latest guidelines for chf

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"heart failure"[MeSH Terms] AND "guidelines"

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CHF congestive heart failure guidelines 2024 2025 ACC AHA ESC latest recommendations

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https://reference.medscape.com/cc1/p10/heart-failure-reduced…

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Reading Article

PMID: 40533340

Here is a comprehensive summary of the latest CHF (Heart Failure) guidelines, drawing from the 2025 NICE update, 2023 ESC Focused Update, 2022 AHA/ACC/HFSA guidelines, and the brand-new 2025 iCARDIO Global Implementation Guidelines (PMID 40533340):

Latest Guidelines for Congestive Heart Failure (CHF) - 2025

1. Classification (All Guidelines)

Type	EF	Key Features
HFrEF	< 40%	Reduced ejection fraction - most evidence-based therapies
HFmrEF	40-49%	Mid-range - emerging evidence
HFpEF	≥ 50%	Preserved EF - historically hard to treat

2. Diagnosis

NT-proBNP / BNP is the cornerstone lab test for diagnosis across NICE, ESC, and AHA/ACC/HFSA
- NT-proBNP 125-400 ng/L: specialist assessment + echo within 6 weeks
- NT-proBNP > 2000 ng/L: urgent specialist assessment
Echocardiography is mandatory to classify HF type and determine LVEF
Cardiac MRI for selected cases (etiology, myocarditis, cardiomyopathy)
A new 2025 ASE guideline (PMID 40617625) updates echocardiographic criteria for diagnosing diastolic dysfunction and HFpEF

3. The Four Pillars of GDMT (HFrEF) - 2025 Consensus

All three major guidelines (NICE 2025, ESC, AHA/ACC/HFSA) now recommend quadruplet therapy - start ALL four and uptitrate to the maximum tolerated dose:

Pillar	Drug Class	Examples	Notes
1	ACEi / ARB / ARNI	Ramipril, Enalapril / Valsartan / Sacubitril-Valsartan	ESC: ACEi preferred first-line; ARNI if still symptomatic. AHA/ACC: ARNI may be used first-line
2	Beta-blocker	Carvedilol, Bisoprolol, Metoprolol succinate	Only these 3 have mortality evidence in HFrEF
3	MRA (Mineralocorticoid Receptor Antagonist)	Spironolactone, Eplerenone	Monitor K+ and renal function
4	SGLT2 inhibitor	Dapagliflozin, Empagliflozin	Class I recommendation across all major guidelines; once-daily, no titration needed

2025 NICE key change: No longer recommends sequencing - start all 4 based on patient profile, frailty, and preferences.

4. SGLT2 Inhibitors - 2025 Update

The DAPA-HF and EMPEROR-Reduced trials confirmed that SGLT2 inhibitors reduce CV death + HF hospitalizations by ~25% in HFrEF regardless of diabetes status. Key advantages per Fuster and Hurst's The Heart, 15th Ed:

Once-daily, no dose titration
Minimal drug-drug interactions
Osmotic diuresis synergistic with loop diuretics
Kidney-protective benefits
Favorable electrolyte profile (no hyperkalemia)

5. Symptomatic / Volume Management

Loop diuretics (furosemide, torsemide) for fluid overload - essential but NOT monotherapy
IV loop diuretics within 1 hour of presentation in hospitalized patients, at or above the chronic oral dose
Avoid thiazides when GFR < 30 mL/min (except combined with loop diuretics)
Daily weight monitoring and flexible diuretic regimens recommended
IV iron (ferric carboxymaltose): emerging evidence supports its use in HFrEF with iron deficiency - recommended in ESC and 2025 guidelines

6. Additional Pharmacotherapy

Drug	Indication	Guideline Rec
Ivabradine	HFrEF, LVEF ≤ 35%, HR ≥ 70 bpm on max beta-blocker, sinus rhythm	Class IIa (ESC, AHA)
Hydralazine + Isosorbide dinitrate	HFrEF intolerant of ACEi/ARB (esp. Black patients)	Class I (AHA/ACC)
Digoxin	HFrEF with persistent symptoms, AF	Class IIb
Vericiguat	Worsening HFrEF on optimal therapy	Class IIb (ESC); considered (AHA/ACC)

7. Device Therapy

ICD for primary prevention: LVEF ≤ 35%, NYHA Class II-III on optimal GDMT for ≥ 3 months, life expectancy > 1 year
CRT: LVEF ≤ 35%, LBBB with QRS ≥ 130-150 ms, NYHA II-IV - mortality and symptom benefit in both sexes
LVAD: Bridge to transplant or destination therapy in advanced HFrEF
Note from Braunwald's Heart Disease: ICDs and CRT are significantly underused in women despite equal or greater benefit

8. HFpEF (EF ≥ 50%)

Previously had no proven mortality-reducing therapies
SGLT2 inhibitors now have emerging evidence for HFpEF (EMPEROR-Preserved trial) - recommended by ESC and AHA/ACC
ARNI (sacubitril/valsartan): PARAGON-HF showed significant benefit specifically in women with HFpEF (28% reduction in HF hospitalization/CV death) - Braunwald's Heart Disease
Treat underlying causes: HTN control, rate control in AF, weight loss in obesity

9. New 2025 Global Guidelines

The iCARDIO Alliance Global Implementation Guidelines 2025 (PMID 40533340, Heart Lung Circ, Jul 2025) address a major gap - providing tiered recommendations based on resource availability:

Standard resources: full quadruplet GDMT + devices
Limited resources: prioritize ACEi/ARB + beta-blocker + diuretic
Severely limited resources: minimum viable regimen with locally available drugs

Key Guidelines Reference Summary

Guideline	Year	Publisher	Scope
AHA/ACC/HFSA Heart Failure Guideline	2022 (updated 2024)	ACC/AHA	Comprehensive US guideline
ESC Focused Update	2023	European Society of Cardiology	HFrEF, HFmrEF, HFpEF
NICE NG106 Update	2025	NICE (UK)	Chronic HFrEF; removed sequencing
iCARDIO Global Guidelines	2025	Heart Lung Circ	Global, resource-adjusted
ASE Diastolic Function Update	2025	J Am Soc Echocardiogr	HFpEF diagnosis by echo

Sources: Fuster and Hurst's The Heart, 15th Ed.; Braunwald's Heart Disease; Medscape 2026 Guideline Essentials; PMID 40533340; PMID 40617625

Would you like me to go deeper into any specific area - HFpEF management, acute decompensated HF, or device therapy?

Make flashcards for MI

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Generating Image

Medical flashcard for advanced clinical exam. Clean dark navy blue background. FRONT side label at top left in small yellow text: "CARD 1 — PATHOPHYSIOLOGY" Large bold white question in center: "What is the pathophysiology of MI?" Small yellow subtitle: "Hint: Plaque → Thrombus → Necrosis" BACK side (right half of card, separated by a thin gold dividing line): Bold white heading: "ANSWER" Bullet points in light cyan text (small, neat): • Atherosclerotic plaque rupture or erosion • Platelet aggregation → thrombus formation • Complete occlusion → ischemia → infarction • Zone of necrosis (core) + zone of injury + zone of ischemia • Type 1 MI: plaque rupture | Type 2 MI: supply-demand mismatch • Irreversible necrosis begins at 20–40 min of ischemia Small white italic footer: "Source: Harrison's 22E | Fuster & Hurst 15E"

Generating Image

Medical flashcard for advanced clinical exam. Clean dark navy blue background. FRONT side label at top left in small yellow text: "CARD 2 — ECG DIAGNOSIS" Large bold white question in center: "ECG criteria for STEMI vs NSTEMI?" Small yellow subtitle: "Lead groupings, thresholds, evolution" BACK side (right half, separated by thin gold vertical line): Bold white heading: "ANSWER" Bullet points in light cyan (small neat): • STEMI: new ST elevation ≥0.1 mV (2 contiguous leads); V2-V3: ≥0.2 mV (men ≥40y), ≥0.25 mV (men <40y), ≥0.15 mV (women) • Earliest sign: Hyperacute T-waves (tall, broad, symmetric) • Evolution: Hyperacute T → ST elevation → Q waves → T-wave inversion • NSTEMI: ST depression or T-wave inversion + elevated troponin • Posterior MI: ST depression V1-V4 (mirror image) • New LBBB may represent STEMI equivalent • Contiguous leads: I/aVL (lateral), II/III/aVF (inferior), V1-V4 (anterior) Small white italic footer: "Source: Frameworks for Internal Medicine | Harrison's 22E"

Generating Image

Medical flashcard for advanced clinical exam. Clean dark navy blue background. FRONT side label at top left in small yellow text: "CARD 3 — BIOMARKERS" Large bold white question in center: "Cardiac biomarkers in MI — timing & significance" Small yellow subtitle: "Rise, peak, normalize" BACK side (right half, separated by thin gold vertical line): Bold white heading: "ANSWER" Small table in white/cyan text: Troponin I/T (hs-cTn): Rise 1-3h | Peak 12-24h | Normalizes 7-14d | MOST SENSITIVE & SPECIFIC CK-MB: Rise 3-4h | Peak 18-24h | Normalizes 48-72h | Useful for reinfarction Myoglobin: Rise 1-2h | Peak 6-9h | Normalizes 24h | Earliest but non-specific BNP/NT-proBNP: Reflects LV dysfunction / prognosis Key points in cyan bullets: • hs-cTn: diagnose MI if delta rise ≥20% at 1-3h (0h/1h or 0h/2h protocols) • Troponin rises in: PE, myocarditis, sepsis, AKI (non-MI causes) • Serial troponins mandatory if first negative but high suspicion Small white italic footer: "Source: Tietz Lab Medicine 7E | Goldman-Cecil"

Generating Image

Medical flashcard for advanced clinical exam. Clean dark navy blue background. FRONT side label at top left in small yellow text: "CARD 4 — STEMI MANAGEMENT" Large bold white question in center: "Acute STEMI management — time targets & reperfusion" Small yellow subtitle: "Door-to-balloon, fibrinolysis, MONA" BACK side (right half, separated by thin gold vertical line): Bold white heading: "ANSWER" Bullet points in light cyan (small neat): TIME TARGETS: • First medical contact → ECG: ≤10 minutes • Door-to-balloon (primary PCI): ≤90 min (PCI-capable center) • Door-to-needle (fibrinolysis): ≤30 min (non-PCI center) • FMC-to-device if transferred: ≤120 min PRIMARY PCI preferred if: • Skilled lab available within 90-120 min • Cardiogenic shock | failed fibrinolysis | late presentation FIBRINOLYSIS if PCI unavailable: • Alteplase, Tenecteplase, Reteplase • Contraindicated: prior ICH, active bleeding, aortic dissection INITIAL DRUGS (MONA-B): Morphine | Oxygen (if SpO2 <90%) | Nitrates | Aspirin 325mg + P2Y12 | Beta-blocker | Heparin Small white italic footer: "Source: Tintinalli EM | Fuster & Hurst 15E | Harrison's 22E"

Generating Image

Medical flashcard for advanced clinical exam. Clean dark navy blue background. FRONT side label at top left in small yellow text: "CARD 5 — ANTIPLATELET & ANTICOAGULATION" Large bold white question in center: "Antithrombotic therapy in ACS — drugs & indications" Small yellow subtitle: "Dual antiplatelet, heparin, GIIb/IIIa" BACK side (right half, separated by thin gold vertical line): Bold white heading: "ANSWER" Bullet points in light cyan (small neat): ANTIPLATELET (DAPT): • Aspirin 162-325mg load → 75-100mg daily (indefinite) • P2Y12 inhibitors: Ticagrelor 180mg load (preferred in NSTEMI/STEMI) | Prasugrel 60mg (STEMI with PCI) | Clopidogrel 600mg (if no access to above) • DAPT duration: 12 months post-ACS (can extend or shorten based on bleeding risk) ANTICOAGULATION: • UFH: weight-based IV bolus + infusion (preferred in STEMI PCI) • Enoxaparin: 1mg/kg SC q12h (NSTEMI/NSTE-ACS) • Fondaparinux: preferred in NSTEMI if no PCI planned (lower bleeding risk) • Bivalirudin: alternative in PCI (direct thrombin inhibitor) GIIb/IIIa inhibitors (abciximab, eptifibatide): selected high-risk PCI cases Small white italic footer: "Source: Harrison's 22E | Fuster & Hurst 15E"

Generating Image

Medical flashcard for advanced clinical exam. Clean dark navy blue background. FRONT side label at top left in small yellow text: "CARD 6 — COMPLICATIONS" Large bold white question in center: "Major complications of MI — timing & management" Small yellow subtitle: "Killip classification, mechanical, electrical" BACK side (right half, separated by thin gold vertical line): Bold white heading: "ANSWER" Text in light cyan (small neat): KILLIP CLASS (mortality ↑ with class): I: No HF (6%) | II: S3/rales (17%) | III: Pulmonary edema (38%) | IV: Cardiogenic shock (81%) MECHANICAL (days 3-7): • Free wall rupture → hemopericardium, tamponade (surgical emergency) • Papillary muscle rupture → acute MR → flash pulmonary edema • VSD (ventricular septal defect) → left-to-right shunt, step-up in O2 saturation at RV ELECTRICAL: • VF/VT: most common cause of death pre-hospital • Complete heart block: inferior MI (RCA) → atropine/pacing • Accelerated idioventricular rhythm: reperfusion arrhythmia (benign) OTHER: • Dressler syndrome (2-10 weeks): pericarditis + pleuritis (immune-mediated) • LV thrombus → anticoagulate • Cardiogenic shock: IABP ± mechanical support, revascularization Small white italic footer: "Source: Goldman-Cecil | Robbins Pathology | Harrison's 22E"

Generating Image

Medical flashcard for advanced clinical exam. Clean dark navy blue background. FRONT side label at top left in small yellow text: "CARD 7 — CORONARY ARTERY TERRITORIES" Large bold white question in center: "Which coronary artery supplies which territory?" Small yellow subtitle: "LAD, RCA, LCX — ECG leads & clinical correlates" BACK side (right half, separated by thin gold vertical line): Bold white heading: "ANSWER" Bullet points in light cyan (small neat): LAD (Left Anterior Descending): • Territory: Anterior wall, septum, apex, anterior papillary muscle • ECG leads: V1-V4 (anterior) • Risk: Large MI, LBBB, high-degree AV block, cardiogenic shock RCA (Right Coronary Artery): • Territory: Inferior wall, RV, SA node (60%), AV node (90%) • ECG leads: II, III, aVF (inferior); check right-sided leads (V4R) for RV MI • Risk: Bradycardia, AV block, RV infarction (hypotension + JVD + no pulmonary edema) LCX (Left Circumflex): • Territory: Lateral wall, posterior wall (in dominant LCx) • ECG leads: I, aVL, V5-V6 (lateral); posterior MI → ST depression V1-V3 • Often "silent" on standard ECG; use posterior leads V7-V9 Small white italic footer: "Source: Fuster & Hurst 15E | Harrison's 22E"

Generating Image

Medical flashcard for advanced clinical exam. Clean dark navy blue background. FRONT side label at top left in small yellow text: "CARD 8 — SECONDARY PREVENTION" Large bold white question in center: "Secondary prevention after MI — which drugs & why?" Small yellow subtitle: "Long-term medications, targets, duration" BACK side (right half, separated by thin gold vertical line): Bold white heading: "ANSWER" Bullet points in light cyan (small neat): MEDICATIONS (start before discharge): • Aspirin: 75-100mg daily — indefinite • P2Y12 inhibitor (ticagrelor/clopidogrel): 12 months post-ACS • High-intensity statin: Atorvastatin 40-80mg or Rosuvastatin 20-40mg — indefinite; target LDL <55 mg/dL (ESC) / <70 mg/dL (ACC) • Beta-blocker: All post-MI with HFrEF (LVEF ≤40%) for ≥3 years; reduces sudden death • ACE inhibitor / ARB: if LVEF ≤40%, diabetes, hypertension — indefinite • MRA (eplerenone/spironolactone): if LVEF ≤40% + HF symptoms or diabetes • SGLT2 inhibitor: if HFrEF post-MI (dapagliflozin / empagliflozin) TARGETS: • LDL <55 mg/dL | BP <130/80 | HbA1c <7% | BMI <25 | Stop smoking DEVICES: • ICD if LVEF ≤35% after ≥40 days post-MI + optimal GDMT ≥3 months Small white italic footer: "Source: Harrison's 22E | ESC 2023 ACS Guidelines | Fuster & Hurst 15E"

Here are your 8 Advanced MI Flashcards, sourced from Harrison's 22E, Fuster & Hurst's The Heart 15E, Goldman-Cecil, and Tintinalli's EM:

🃏 Card 1 — Pathophysiology

🃏 Card 2 — ECG Diagnosis

🃏 Card 3 — Biomarkers

🃏 Card 4 — STEMI Management & Reperfusion

🃏 Card 5 — Antiplatelet & Anticoagulation

🃏 Card 6 — Complications (Killip + Mechanical + Electrical)

🃏 Card 7 — Coronary Artery Territories

🃏 Card 8 — Secondary Prevention

Topics covered:

Pathophysiology (plaque rupture, ischemia timeline)
ECG criteria (STEMI vs NSTEMI, lead territories, evolution)
Biomarkers (troponin, CK-MB timing + delta rise protocols)
STEMI management (door-to-balloon targets, fibrinolysis, MONA-B)
Antithrombotic therapy (DAPT, heparin types, GIIb/IIIa)
Complications (Killip class, free wall rupture, VSD, arrhythmias, Dressler's)
Coronary territories (LAD/RCA/LCX and ECG correlates)
Secondary prevention (statins, GDMT, LDL targets, ICD criteria)

Want me to add more cards (e.g., RV infarction, NSTEMI risk stratification, cardiogenic shock), or export these as a downloadable PDF/PPTX deck?

Export flashcards as a PPTX deck for studying

Reading File

Running Command

python /tmp/skills/shared/scripts/fetch_images.py \ "https://cdn.orris.care/image-gen/52444ccd5da64fae8d91ae1f24ff029a.png" \ "https://cdn.orris.care/image-gen/aaf1b08d735b4ec392556c3082f9391a.png" \ "https://cdn.orris.care/image-gen/c925c65156f4447696a0e50acb66aab0.png" \ "https://cdn.orris.care/image-gen/9cf95434868f42e79bf09a9abe480ee3.png" \ "https://cdn.orris.care/image-gen/eb8f4e9c78ba4066bb5453bfdab71da8.png" \ "https://cdn.orris.care/image-gen/dfde69a1dd6f4471bb5deab3e04ecc28.png" \ "https://cdn.orris.care/image-gen/48147771a3f142168b4e1476133c8b63.png" \ "https://cdn.orris.care/image-gen/b8f9906fd783433aa6a57bad471bb9f9.png" \ 2>/dev/null | python3 -c "import sys,json; data=json.load(sys.stdin); print('OK:', len([x for x in data if x['base64']]), 'images fetched'); [print('FAIL:', x['url']) for x in data if not x['base64']]"

Running Command

mkdir -p /tmp/workspace/mi-flashcards && python3 << 'PYEOF' import json, subprocess, base64 from io import BytesIO from pptx import Presentation from pptx.util import Inches, Pt, Emu from pptx.dml.color import RGBColor from pptx.enum.text import PP_ALIGN, MSO_ANCHOR URLS = [ ("Card 1 — Pathophysiology", "https://cdn.orris.care/image-gen/52444ccd5da64fae8d91ae1f24ff029a.png"), ("Card 2 — ECG Diagnosis", "https://cdn.orris.care/image-gen/aaf1b08d735b4ec392556c3082f9391a.png"), ("Card 3 — Biomarkers", "https://cdn.orris.care/image-gen/c925c65156f4447696a0e50acb66aab0.png"), ("Card 4 — STEMI Management", "https://cdn.orris.care/image-gen/9cf95434868f42e79bf09a9abe480ee3.png"), ("Card 5 — Antiplatelet & Anticoag", "https://cdn.orris.care/image-gen/eb8f4e9c78ba4066bb5453bfdab71da8.png"), ("Card 6 — Complications", "https://cdn.orris.care/image-gen/dfde69a1dd6f4471bb5deab3e04ecc28.png"), ("Card 7 — Coronary Territories", "https://cdn.orris.care/image-gen/48147771a3f142168b4e1476133c8b63.png"), ("Card 8 — Secondary Prevention", "https://cdn.orris.care/image-gen/b8f9906fd783433aa6a57bad471bb9f9.png"), ] # Fetch all images raw_result = subprocess.check_output( ["python", "/tmp/skills/shared/scripts/fetch_images.py"] + [u for _, u in URLS] ) img_data = json.loads(raw_result) # Build presentation prs = Presentation() prs.slide_width = Inches(13.333) prs.slide_height = Inches(7.5) blank_layout = prs.slide_layouts[6] # ── Title slide ───────────────────────────────────────────────────────────── title_slide = prs.slides.add_slide(blank_layout) # Navy background bg = title_slide.shapes.add_shape( 1, 0, 0, prs.slide_width, prs.slide_height) # MSO_SHAPE.RECTANGLE = 1 bg.fill.solid(); bg.fill.fore_color.rgb = RGBColor(0x0D, 0x1B, 0x3E) bg.line.fill.background() # Gold accent bar bar = title_slide.shapes.add_shape( 1, Inches(1.5), Inches(2.8), Inches(10.3), Inches(0.06)) bar.fill.solid(); bar.fill.fore_color.rgb = RGBColor(0xF5, 0xC5, 0x18) bar.line.fill.background() # Title text tb = title_slide.shapes.add_textbox(Inches(1.5), Inches(1.3), Inches(10.3), Inches(1.3)) tf = tb.text_frame; tf.word_wrap = True p = tf.paragraphs[0] p.alignment = PP_ALIGN.CENTER r = p.add_run() r.text = "MYOCARDIAL INFARCTION" r.font.name = "Arial"; r.font.size = Pt(46); r.font.bold = True r.font.color.rgb = RGBColor(0xFF, 0xFF, 0xFF) # Subtitle tb2 = title_slide.shapes.add_textbox(Inches(1.5), Inches(3.1), Inches(10.3), Inches(0.7)) tf2 = tb2.text_frame p2 = tf2.paragraphs[0] p2.alignment = PP_ALIGN.CENTER r2 = p2.add_run() r2.text = "Advanced Clinical Flashcards — 8 Cards" r2.font.name = "Arial"; r2.font.size = Pt(22); r2.font.bold = False r2.font.color.rgb = RGBColor(0xF5, 0xC5, 0x18) # Source line tb3 = title_slide.shapes.add_textbox(Inches(1.5), Inches(4.0), Inches(10.3), Inches(0.55)) tf3 = tb3.text_frame p3 = tf3.paragraphs[0] p3.alignment = PP_ALIGN.CENTER r3 = p3.add_run() r3.text = "Harrison's 22E | Fuster & Hurst 15E | Goldman-Cecil | Tintinalli EM" r3.font.name = "Arial"; r3.font.size = Pt(14) r3.font.color.rgb = RGBColor(0xAA, 0xBB, 0xDD) # Topics list topics = [ "Pathophysiology", "ECG Diagnosis", "Biomarkers", "STEMI Management", "Antiplatelet & Anticoagulation", "Complications", "Coronary Territories", "Secondary Prevention" ] tb4 = title_slide.shapes.add_textbox(Inches(2.0), Inches(4.8), Inches(9.3), Inches(2.2)) tf4 = tb4.text_frame; tf4.word_wrap = True first = True for i, topic in enumerate(topics, 1): if first: p4 = tf4.paragraphs[0]; first = False else: p4 = tf4.add_paragraph() p4.alignment = PP_ALIGN.CENTER r4 = p4.add_run() r4.text = f"{' '.join([''] * 0)}{i}. {topic}" r4.font.name = "Arial"; r4.font.size = Pt(12) r4.font.color.rgb = RGBColor(0xCC, 0xDD, 0xEE) # ── Flashcard slides (one per card) ───────────────────────────────────────── for (title, url), img_info in zip(URLS, img_data): slide = prs.slides.add_slide(blank_layout) # Dark background bg2 = slide.shapes.add_shape(1, 0, 0, prs.slide_width, prs.slide_height) bg2.fill.solid(); bg2.fill.fore_color.rgb = RGBColor(0x0A, 0x14, 0x30) bg2.line.fill.background() if img_info.get("base64"): raw_bytes = base64.b64decode(img_info["base64"].split(",")[-1]) img_stream = BytesIO(raw_bytes) # Full-slide image (slight padding) slide.shapes.add_picture(img_stream, Inches(0.15), Inches(0.15), Inches(13.0), Inches(7.2)) else: # Fallback text if image failed tb_err = slide.shapes.add_textbox(Inches(1), Inches(2), Inches(11), Inches(3)) tf_err = tb_err.text_frame tf_err.paragraphs[0].text = f"[Image unavailable: {title}]" # ── Save ───────────────────────────────────────────────────────────────────── out_path = "/tmp/workspace/mi-flashcards/MI_Flashcards_Advanced.pptx" buf = BytesIO() prs.save(buf) with open(out_path, "wb") as f: f.write(buf.getvalue()) print(f"Saved: {out_path}") import os print(f"Size: {os.path.getsize(out_path):,} bytes") print(f"Slides: {len(prs.slides)}") PYEOF

Your PPTX deck is ready:

MI Flashcards Advanced

Presentation · PPTX

What's inside (9 slides):

Slide	Content
1	Title slide — topics overview
2	Card 1 — Pathophysiology
3	Card 2 — ECG Diagnosis
4	Card 3 — Biomarkers
5	Card 4 — STEMI Management
6	Card 5 — Antiplatelet & Anticoagulation
7	Card 6 — Complications (Killip + mechanical + electrical)
8	Card 7 — Coronary Territories
9	Card 8 — Secondary Prevention

Study tips:

Use Presenter View in PowerPoint to quiz yourself before revealing the answer side
Each card has both the question and answer on one slide - great for review mode
Works on PowerPoint, Google Slides (upload), and LibreOffice Impress

Make flashcards to remember , make it flip and reveal answer

Running Command

mkdir -p /tmp/workspace/mi-flashcards && ls /tmp/workspace/mi-flashcards/

Writing File

~/mi-flashcards/MI_Flashcards.html

<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8" />
<meta name="viewport" content="width=device-width, initial-scale=1.0"/>
<title>MI Flashcards — Advanced Clinical</title>
<style>
  /* ── Reset & base ── */
  *, *::before, *::after { box-sizing: border-box; margin: 0; padding: 0; }

  body {
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<header>
  <h1>🫀 <span>Myocardial Infarction</span> — Advanced Flashcards</h1>
  <p>Click card or press <strong>Space</strong> to flip &nbsp;·&nbsp; ← → to navigate &nbsp;·&nbsp; 8 cards total</p>
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<script>
const CARDS = [
  {
    topic: "Pathophysiology",
    question: "What is the pathophysiology of myocardial infarction?",
    hint: "Plaque → Thrombus → Necrosis zones",
    heading: "Pathophysiology of MI",
    body: `
      <div class="section">
        <div class="section-title">Core Mechanism</div>
        <ul>
          <li>Atherosclerotic plaque <span class="highlight">rupture or erosion</span> → platelet aggregation → thrombus</li>
          <li>Complete coronary occlusion → ischemia → irreversible necrosis</li>
          <li>Irreversible injury begins at <span class="highlight">20–40 min</span> of sustained ischemia</li>
          <li>Wavefront phenomenon: subendocardium first → transmural over 3–6 h</li>
        </ul>
      </div>
      <div class="section">
        <div class="section-title">Zones of Injury</div>
        <ul>
          <li><span class="highlight">Necrosis</span> (core) → <span class="highlight">Injury</span> → <span class="highlight">Ischemia</span> (outer)</li>
          <li>ECG correlate: Q-wave | ST elevation | T-wave inversion</li>
        </ul>
      </div>
      <div class="section">
        <div class="section-title">MI Classification</div>
        <ul>
          <li><span class="highlight">Type 1:</span> Spontaneous plaque rupture/erosion</li>
          <li><span class="highlight">Type 2:</span> Supply-demand mismatch (e.g. spasm, anaemia, tachycardia)</li>
          <li>Types 3–5: Cardiac death, PCI-related, CABG-related</li>
        </ul>
      </div>`,
    source: "Harrison's 22E | Fuster & Hurst 15E | Robbins Pathology"
  },
  {
    topic: "ECG Diagnosis",
    question: "What are the ECG criteria for STEMI vs NSTEMI, and how do changes evolve?",
    hint: "Lead thresholds vary by sex & age; evolution: T → ST → Q",
    heading: "ECG Criteria & Evolution",
    body: `
      <div class="section">
        <div class="section-title">STEMI Criteria (J-point elevation, 2 contiguous leads)</div>
        <ul>
          <li>Leads other than V2–V3: <span class="highlight">≥ 0.1 mV</span></li>
          <li>V2–V3 men ≥ 40 y: ≥ 0.2 mV &nbsp;|&nbsp; men &lt; 40 y: ≥ 0.25 mV &nbsp;|&nbsp; women: ≥ 0.15 mV</li>
          <li>New LBBB in ischaemic context = STEMI equivalent</li>
        </ul>
      </div>
      <div class="section">
        <div class="section-title">ECG Evolution (STEMI)</div>
        <ul>
          <li><span class="highlight">Minutes:</span> Hyperacute T-waves (tall, broad, symmetric)</li>
          <li><span class="highlight">Hours:</span> ST elevation → Q waves begin</li>
          <li><span class="highlight">Days:</span> T-wave inversion, Q waves deepen</li>
          <li><span class="highlight">Weeks:</span> ST normalises; Q waves may persist</li>
        </ul>
      </div>
      <div class="section">
        <div class="section-title">NSTEMI / UA</div>
        <ul>
          <li>ST depression ≥ 0.5 mm or T-wave inversion + <span class="highlight">elevated troponin</span></li>
          <li>UA = same ECG changes but <span class="highlight">troponin negative</span></li>
        </ul>
      </div>
      <div class="section">
        <div class="section-title">Contiguous Lead Groups</div>
        <ul>
          <li>Inferior: II, III, aVF &nbsp;|&nbsp; Anterior: V1–V4 &nbsp;|&nbsp; Lateral: I, aVL, V5–V6</li>
          <li>Posterior MI: ST depression V1–V3 (mirror); confirm with V7–V9</li>
          <li>RV MI (inferior STEMI): ST elevation in V4R</li>
        </ul>
      </div>`,
    source: "Frameworks for Internal Medicine | Harrison's 22E"
  },
  {
    topic: "Biomarkers",
    question: "What are the key cardiac biomarkers in MI — rise, peak, and normalisation times?",
    hint: "hs-cTn is most sensitive; delta rise protocol at 0h/1h or 0h/2h",
    heading: "Cardiac Biomarker Kinetics",
    body: `
      <div class="section">
        <div class="section-title">High-Sensitivity Troponin I/T (hs-cTn) — Gold Standard</div>
        <ul>
          <li>Rise: <span class="highlight">1–3 h</span> &nbsp;|&nbsp; Peak: 12–24 h &nbsp;|&nbsp; Normalise: 7–14 days</li>
          <li>Delta rise ≥ 20% at 1–2 h = diagnose MI (0h/1h or 0h/2h protocol)</li>
          <li>Most sensitive AND most specific for myocardial necrosis</li>
        </ul>
      </div>
      <div class="section">
        <div class="section-title">CK-MB</div>
        <ul>
          <li>Rise: 3–4 h &nbsp;|&nbsp; Peak: 18–24 h &nbsp;|&nbsp; Normalise: <span class="highlight">48–72 h</span></li>
          <li>Useful for detecting <span class="highlight">reinfarction</span> (normalises faster than troponin)</li>
        </ul>
      </div>
      <div class="section">
        <div class="section-title">Myoglobin</div>
        <ul>
          <li>Rise: <span class="highlight">1–2 h</span> (earliest) &nbsp;|&nbsp; Peak: 6–9 h &nbsp;|&nbsp; Normalise: 24 h</li>
          <li>Non-specific — also elevated in skeletal muscle injury</li>
        </ul>
      </div>
      <div class="section">
        <div class="section-title">Non-MI causes of Troponin Rise</div>
        <ul>
          <li>PE, myocarditis, sepsis, AKI, HF, stroke, cardioversion</li>
          <li><span class="highlight">Demand ischaemia</span> (Type 2 MI) — context is key</li>
        </ul>
      </div>`,
    source: "Tietz Laboratory Medicine 7E | Goldman-Cecil"
  },
  {
    topic: "STEMI Management",
    question: "What are the time targets and reperfusion strategy for STEMI?",
    hint: "Door-to-balloon ≤ 90 min; fibrinolysis ≤ 30 min; MONA-B",
    heading: "Acute STEMI Management",
    body: `
      <div class="section">
        <div class="section-title">Time Targets</div>
        <ul>
          <li>First medical contact → ECG: <span class="highlight">≤ 10 min</span></li>
          <li>Door-to-balloon (primary PCI): <span class="highlight">≤ 90 min</span></li>
          <li>Door-to-needle (fibrinolysis): <span class="highlight">≤ 30 min</span></li>
          <li>FMC-to-device if transferred: <span class="highlight">≤ 120 min</span></li>
        </ul>
      </div>
      <div class="section">
        <div class="section-title">Primary PCI — Preferred When</div>
        <ul>
          <li>Skilled lab available within 90–120 min of FMC</li>
          <li>Cardiogenic shock, failed fibrinolysis, late presentation (&gt; 3 h)</li>
        </ul>
      </div>
      <div class="section">
        <div class="section-title">Fibrinolysis — Use When PCI Unavailable in Time</div>
        <ul>
          <li>Agents: Alteplase, Tenecteplase (weight-based bolus), Reteplase</li>
          <li>Absolute contraindications: prior ICH, active bleeding, aortic dissection, ischaemic stroke &lt; 3 months</li>
        </ul>
      </div>
      <div class="section">
        <div class="section-title">Initial Drug Therapy (MONA-B)</div>
        <ul>
          <li><span class="highlight">M</span>orphine (pain/anxiety) &nbsp;|&nbsp; <span class="highlight">O</span>xygen only if SpO₂ &lt; 90%</li>
          <li><span class="highlight">N</span>itrates (avoid if RV MI, hypotension, PDE-5 use)</li>
          <li><span class="highlight">A</span>spirin 300 mg + P2Y12 inhibitor loading dose</li>
          <li><span class="highlight">B</span>eta-blocker (oral, early if no contraindications) + Heparin</li>
          <li>High-intensity <span class="highlight">statin</span> initiated before discharge</li>
        </ul>
      </div>`,
    source: "Tintinalli EM | Fuster & Hurst 15E | Harrison's 22E"
  },
  {
    topic: "Antiplatelet & Anticoagulation",
    question: "What is the antithrombotic regimen in ACS — DAPT, anticoagulation choices?",
    hint: "Ticagrelor > Prasugrel > Clopidogrel; DAPT 12 months",
    heading: "Antithrombotic Therapy in ACS",
    body: `
      <div class="section">
        <div class="section-title">Dual Antiplatelet Therapy (DAPT)</div>
        <ul>
          <li><span class="highlight">Aspirin</span> 162–325 mg load → 75–100 mg daily (indefinite)</li>
          <li><span class="highlight">Ticagrelor</span> 180 mg load (preferred — PLATO trial, ↓ CV death vs clopidogrel)</li>
          <li><span class="highlight">Prasugrel</span> 60 mg load (STEMI + PCI; avoid if prior TIA/stroke, age ≥ 75, &lt; 60 kg)</li>
          <li><span class="highlight">Clopidogrel</span> 600 mg load (if ticagrelor/prasugrel unavailable or on OAC)</li>
          <li>DAPT duration: <span class="highlight">12 months</span> post-ACS (shorter if high bleed risk; longer if high ischaemic risk)</li>
        </ul>
      </div>
      <div class="section">
        <div class="section-title">Anticoagulation</div>
        <ul>
          <li><span class="highlight">UFH</span>: IV bolus + infusion — preferred for STEMI PCI (easy reversal)</li>
          <li><span class="highlight">Enoxaparin</span>: 1 mg/kg SC q12h — NSTEMI/NSTE-ACS (SYNERGY trial)</li>
          <li><span class="highlight">Fondaparinux</span>: 2.5 mg SC daily — preferred NSTEMI if no PCI planned (lowest bleed risk)</li>
          <li><span class="highlight">Bivalirudin</span>: direct thrombin inhibitor; alternative in PCI (less HIT risk)</li>
        </ul>
      </div>
      <div class="section">
        <div class="section-title">GPIIb/IIIa Inhibitors</div>
        <ul>
          <li>Abciximab, Eptifibatide, Tirofiban — bail-out or high-thrombus-burden PCI only</li>
        </ul>
      </div>`,
    source: "Harrison's 22E | Fuster & Hurst 15E | ESC ACS Guidelines 2023"
  },
  {
    topic: "Complications",
    question: "What are the major complications of MI — mechanical, electrical, and Killip?",
    hint: "Killip class I–IV; mechanical days 3–7; Dressler's at 2–10 weeks",
    heading: "MI Complications",
    body: `
      <div class="section">
        <div class="section-title">Killip Classification (in-hospital mortality)</div>
        <ul>
          <li><span class="highlight">Class I</span>: No HF signs — 6% mortality</li>
          <li><span class="highlight">Class II</span>: S3 gallop / basal rales — 17%</li>
          <li><span class="highlight">Class III</span>: Acute pulmonary oedema — 38%</li>
          <li><span class="highlight">Class IV</span>: Cardiogenic shock (BP &lt; 90, cool peripheries) — 81%</li>
        </ul>
      </div>
      <div class="section">
        <div class="section-title">Mechanical Complications (days 3–7)</div>
        <ul>
          <li><span class="highlight">Free wall rupture</span>: haemopericardium → tamponade → PEA arrest (surgical emergency)</li>
          <li><span class="highlight">Papillary muscle rupture</span>: acute severe MR → flash pulmonary oedema; new loud systolic murmur</li>
          <li><span class="highlight">VSD</span>: left-to-right shunt; step-up in O₂ sat at RV; new harsh pansystolic murmur; echo diagnostic</li>
        </ul>
      </div>
      <div class="section">
        <div class="section-title">Electrical Complications</div>
        <ul>
          <li><span class="highlight">VF/VT</span>: #1 cause of pre-hospital death; defibrillate immediately</li>
          <li><span class="highlight">Complete heart block</span>: inferior MI (RCA) → atropine/temporary pacing</li>
          <li><span class="highlight">AIVR</span>: accelerated idioventricular rhythm = reperfusion arrhythmia; usually benign</li>
        </ul>
      </div>
      <div class="section">
        <div class="section-title">Other</div>
        <ul>
          <li><span class="highlight">Dressler's syndrome</span> (2–10 weeks): immune pericarditis + pleural effusion → treat with aspirin/colchicine</li>
          <li><span class="highlight">LV thrombus</span>: anterior STEMI → anticoagulate 3–6 months</li>
        </ul>
      </div>`,
    source: "Goldman-Cecil | Robbins Pathology | Harrison's 22E"
  },
  {
    topic: "Coronary Territories",
    question: "Which coronary artery supplies which territory — ECG leads and clinical correlates?",
    hint: "LAD → anterior; RCA → inferior + AV node; LCX → lateral/posterior",
    heading: "Coronary Artery Territories",
    body: `
      <div class="section">
        <div class="section-title">LAD (Left Anterior Descending)</div>
        <ul>
          <li>Territory: Anterior wall, <span class="highlight">septum</span>, apex, anterior papillary muscle</li>
          <li>ECG: V1–V4 (anterior STEMI)</li>
          <li>Risks: Large MI, new LBBB, high-degree AV block, cardiogenic shock, apical thrombus</li>
        </ul>
      </div>
      <div class="section">
        <div class="section-title">RCA (Right Coronary Artery)</div>
        <ul>
          <li>Territory: <span class="highlight">Inferior wall</span>, RV, SA node (60%), AV node (90%) in right-dominant hearts</li>
          <li>ECG: II, III, aVF; check V4R for RV infarction</li>
          <li><span class="highlight">RV MI triad</span>: hypotension + raised JVP + clear lungs (no diuretics/nitrates!)</li>
          <li>Risks: Brady/AV block → atropine or pacing</li>
        </ul>
      </div>
      <div class="section">
        <div class="section-title">LCX (Left Circumflex)</div>
        <ul>
          <li>Territory: <span class="highlight">Lateral wall</span>; posterior wall if dominant LCx</li>
          <li>ECG: I, aVL, V5–V6; posterior MI → ST depression V1–V3, confirm V7–V9</li>
          <li>Often "electrically silent" on standard 12-lead — do posterior leads if suspicious</li>
        </ul>
      </div>`,
    source: "Fuster & Hurst 15E | Harrison's 22E"
  },
  {
    topic: "Secondary Prevention",
    question: "What medications and targets are used for secondary prevention after MI?",
    hint: "DAPT + statin + ACEi/ARB + BB + MRA + SGLT2i; LDL < 55 mg/dL",
    heading: "Secondary Prevention Post-MI",
    body: `
      <div class="section">
        <div class="section-title">Mandatory Medications (start before discharge)</div>
        <ul>
          <li><span class="highlight">Aspirin</span> 75–100 mg — indefinite</li>
          <li><span class="highlight">P2Y12 inhibitor</span> (ticagrelor/clopidogrel) — 12 months</li>
          <li><span class="highlight">High-intensity statin</span> — atorvastatin 40–80 mg or rosuvastatin 20–40 mg, indefinite</li>
          <li><span class="highlight">Beta-blocker</span> — all with LVEF ≤ 40% for ≥ 3 years; reduces sudden cardiac death</li>
          <li><span class="highlight">ACE inhibitor / ARB</span> — if LVEF ≤ 40%, DM, or HTN — indefinite</li>
        </ul>
      </div>
      <div class="section">
        <div class="section-title">Additional (if LVEF ≤ 40%)</div>
        <ul>
          <li><span class="highlight">MRA</span> (eplerenone/spironolactone) — if HF symptoms or DM</li>
          <li><span class="highlight">SGLT2 inhibitor</span> (dapagliflozin/empagliflozin) — if HFrEF post-MI</li>
        </ul>
      </div>
      <div class="section">
        <div class="section-title">Treatment Targets</div>
        <ul>
          <li>LDL: <span class="highlight">&lt; 55 mg/dL</span> (ESC) / &lt; 70 mg/dL (ACC) — add ezetimibe or PCSK9i if needed</li>
          <li>BP: &lt; 130/80 mmHg &nbsp;|&nbsp; HbA1c: &lt; 7% &nbsp;|&nbsp; BMI: &lt; 25 &nbsp;|&nbsp; Smoking: cessation</li>
        </ul>
      </div>
      <div class="section">
        <div class="section-title">Device Therapy</div>
        <ul>
          <li><span class="highlight">ICD</span>: LVEF ≤ 35% after ≥ 40 days post-MI + GDMT ≥ 3 months + life expectancy &gt; 1 year</li>
          <li>Cardiac rehabilitation — all post-MI patients</li>
        </ul>
      </div>`,
    source: "Harrison's 22E | ESC ACS Guidelines 2023 | Fuster & Hurst 15E"
  }
];

let current = 0;
let isFlipped = false;
let order = CARDS.map((_, i) => i);
let seen = new Set();

function renderCard(idx, flip) {
  const c = CARDS[order[idx]];
  document.getElementById('cardNum').textContent   = `Card ${idx + 1} of ${CARDS.length}`;
  document.getElementById('backNum').textContent   = `✓ CARD ${idx + 1} — ANSWER`;
  document.getElementById('frontTopic').textContent    = c.topic;
  document.getElementById('frontQuestion').textContent = c.question;
  document.getElementById('frontHint').textContent     = c.hint ? `💡 ${c.hint}` : '';
  document.getElementById('backHeading').textContent   = c.heading;
  document.getElementById('backBody').innerHTML        = c.body;
  document.getElementById('backSource').textContent    = `📚 ${c.source}`;

  const cardEl = document.getElementById('card');
  // Remove flip, apply instantly
  cardEl.style.transition = 'none';
  cardEl.classList.remove('flipped');
  // Force reflow
  void cardEl.offsetWidth;
  cardEl.style.transition = '';

  isFlipped = false;
  if (flip) { cardEl.classList.add('flipped'); isFlipped = true; }

  // Progress
  const pct = ((idx + 1) / CARDS.length) * 100;
  document.getElementById('progressFill').style.width = pct + '%';
  document.getElementById('progressText').textContent = `${idx + 1} / ${CARDS.length}`;

  // Buttons
  document.getElementById('btnPrev').disabled = (idx === 0);
  document.getElementById('btnNext').disabled = (idx === CARDS.length - 1);

  // Dots
  document.querySelectorAll('.dot').forEach((d, i) => {
    d.className = 'dot' + (i === idx ? ' active' : '') + (seen.has(i) && i !== idx ? ' seen' : '');
  });
}

function flipCard() {
  const cardEl = document.getElementById('card');
  if (isFlipped) {
    cardEl.classList.remove('flipped');
    isFlipped = false;
  } else {
    cardEl.classList.add('flipped');
    isFlipped = true;
    seen.add(current);
    renderDots();
  }
}

function renderDots() {
  document.querySelectorAll('.dot').forEach((d, i) => {
    d.className = 'dot' + (i === current ? ' active' : '') + (seen.has(i) && i !== current ? ' seen' : '');
  });
}

function nextCard() {
  if (current < CARDS.length - 1) {
    current++;
    renderCard(current, false);
  }
}

function prevCard() {
  if (current > 0) {
    current--;
    renderCard(current, false);
  }
}

function goToCard(idx) {
  current = idx;
  renderCard(current, false);
}

function shuffleCards() {
  for (let i = order.length - 1; i > 0; i--) {
    const j = Math.floor(Math.random() * (i + 1));
    [order[i], order[j]] = [order[j], order[i]];
  }
  current = 0;
  seen.clear();
  renderCard(current, false);
}

// Build dots
const dotsEl = document.getElementById('dots');
CARDS.forEach((_, i) => {
  const d = document.createElement('div');
  d.className = 'dot' + (i === 0 ? ' active' : '');
  d.title = CARDS[i].topic;
  d.onclick = () => goToCard(i);
  dotsEl.appendChild(d);
});

// Keyboard nav
document.addEventListener('keydown', e => {
  if (e.code === 'Space' || e.key === ' ')   { e.preventDefault(); flipCard(); }
  if (e.key === 'ArrowRight')                { nextCard(); }
  if (e.key === 'ArrowLeft')                 { prevCard(); }
  if (e.key === 's' || e.key === 'S')        { shuffleCards(); }
});

// Initial render
renderCard(0, false);
</script>
</body>
</html>

Running Command

python3 -c " from html.parser import HTMLParser import os path = '/tmp/workspace/mi-flashcards/MI_Flashcards.html' size = os.path.getsize(path) print(f'File size: {size:,} bytes') # Basic validation with open(path) as f: content = f.read() checks = [ ('DOCTYPE', '<!DOCTYPE html>' in content), ('8 cards defined', content.count('topic:') == 8), ('Flip animation CSS', 'rotateY(180deg)' in content), ('backface-visibility', 'backface-visibility: hidden' in content), ('Keyboard nav', 'ArrowRight' in content), ('Shuffle function', 'shuffleCards' in content), ('Progress bar', 'progressFill' in content), ('Dot indicators', 'dot active' in content or \"'dot'\" in content), ('All 8 topics present', all(t in content for t in [ 'Pathophysiology','ECG Diagnosis','Biomarkers','STEMI Management', 'Antiplatelet','Complications','Coronary Territories','Secondary Prevention' ])), ] for label, ok in checks: print(f\" {'✓' if ok else '✗'} {label}\") "

All 9 checks passed. Here's your interactive flip flashcard deck:

MI Flashcards

HTML File · HTML

Download and open in any browser (Chrome, Firefox, Safari, Edge) - no internet needed.

How it works:

Action	Control
Flip card (reveal answer)	Click the card, click "Flip Card" button, or press `Space`
Next card	Click "Next ▶" or press `→`
Previous card	Click "◀ Prev" or press `←`
Shuffle	Click "⇄ Shuffle" or press `S`
Jump to any card	Click the dot indicators at the bottom

Features:

Smooth 3D flip animation - front (question) flips to reveal the back (answer)
Front - dark navy with yellow topic label and question
Back - dark green with structured bullet answers and highlighted key facts
Progress bar showing how far through the deck you are
Dot indicators that turn green once you've seen a card
Shuffle mode to randomise the order for self-testing
Works fully offline after downloading

Export flashcards as a mobile-friendly app (PWA)

Running Command

mkdir -p /tmp/workspace/mi-pwa/icons && ls /tmp/workspace/mi-pwa/

Running Command

python3 << 'PYEOF' # Generate PNG icons (192x192 and 512x512) with Pillow from PIL import Image, ImageDraw, ImageFont import os def make_icon(size, path): img = Image.new("RGB", (size, size), color=(13, 27, 62)) d = ImageDraw.Draw(img) # Gold circle background margin = int(size * 0.08) d.ellipse([margin, margin, size-margin, size-margin], fill=(245, 197, 24)) # Heart emoji approximation: red heart shape # Draw a simple red heart using two circles + triangle cx, cy = size // 2, int(size * 0.47) r = int(size * 0.18) # Two circles d.ellipse([cx - r*2, cy - r, cx, cy + r], fill=(200, 30, 40)) d.ellipse([cx, cy - r, cx + r*2, cy + r], fill=(200, 30, 40)) # Triangle bottom d.polygon([ (cx - r*2, cy + int(r*0.3)), (cx + r*2, cy + int(r*0.3)), (cx, cy + int(r*2.2)) ], fill=(200, 30, 40)) # White "MI" text try: font = ImageFont.truetype("/usr/share/fonts/truetype/dejavu/DejaVuSans-Bold.ttf", int(size * 0.13)) except: font = ImageFont.load_default() text = "MI" bbox = d.textbbox((0,0), text, font=font) tw, th = bbox[2]-bbox[0], bbox[3]-bbox[1] d.text((cx - tw//2, cy + int(r*2.5) - th//2), text, fill=(255,255,255), font=font) img.save(path, "PNG") print(f" Created {path} ({size}x{size})") make_icon(192, "/tmp/workspace/mi-pwa/icons/icon-192.png") make_icon(512, "/tmp/workspace/mi-pwa/icons/icon-512.png") print("Icons done.") PYEOF

Writing File

~/mi-pwa/manifest.json

{
  "name": "MI Flashcards — Advanced Clinical",
  "short_name": "MI Cards",
  "description": "Advanced myocardial infarction flashcards for clinical exam preparation. Covers pathophysiology, ECG, biomarkers, STEMI management, complications, and secondary prevention.",
  "start_url": "./index.html",
  "display": "standalone",
  "background_color": "#0b1120",
  "theme_color": "#0b1120",
  "orientation": "any",
  "scope": "./",
  "lang": "en",
  "categories": ["education", "medical", "health"],
  "icons": [
    {
      "src": "icons/icon-192.png",
      "sizes": "192x192",
      "type": "image/png",
      "purpose": "any maskable"
    },
    {
      "src": "icons/icon-512.png",
      "sizes": "512x512",
      "type": "image/png",
      "purpose": "any maskable"
    }
  ]
}

Writing File

~/mi-pwa/sw.js

// MI Flashcards PWA — Service Worker
// Cache version — bump this string to force cache refresh
const CACHE_NAME = 'mi-flashcards-v1';

// All files to cache for offline use
const ASSETS = [
  './index.html',
  './manifest.json',
  './icons/icon-192.png',
  './icons/icon-512.png'
];

// ── Install: pre-cache all assets ──────────────────────────────────────────
self.addEventListener('install', event => {
  event.waitUntil(
    caches.open(CACHE_NAME).then(cache => {
      return cache.addAll(ASSETS);
    })
  );
  self.skipWaiting();
});

// ── Activate: remove old caches ────────────────────────────────────────────
self.addEventListener('activate', event => {
  event.waitUntil(
    caches.keys().then(keys =>
      Promise.all(
        keys.filter(k => k !== CACHE_NAME).map(k => caches.delete(k))
      )
    )
  );
  self.clients.claim();
});

// ── Fetch: cache-first strategy ────────────────────────────────────────────
self.addEventListener('fetch', event => {
  event.respondWith(
    caches.match(event.request).then(cached => {
      if (cached) return cached;
      return fetch(event.request).then(response => {
        // Cache new successful GET responses
        if (event.request.method === 'GET' && response.status === 200) {
          const clone = response.clone();
          caches.open(CACHE_NAME).then(cache => cache.put(event.request, clone));
        }
        return response;
      }).catch(() => {
        // Return index.html as fallback for navigation requests
        if (event.request.mode === 'navigate') {
          return caches.match('./index.html');
        }
      });
    })
  );
});

Writing File

~/mi-pwa/index.html

<!DOCTYPE html>
<html lang="en">
<head>
<meta charset="UTF-8"/>
<meta name="viewport" content="width=device-width, initial-scale=1.0, viewport-fit=cover"/>
<meta name="theme-color" content="#0b1120"/>
<meta name="apple-mobile-web-app-capable" content="yes"/>
<meta name="apple-mobile-web-app-status-bar-style" content="black-translucent"/>
<meta name="apple-mobile-web-app-title" content="MI Cards"/>
<meta name="description" content="Advanced MI flashcards for clinical exam preparation — flip cards, offline-ready PWA"/>
<link rel="manifest" href="manifest.json"/>
<link rel="apple-touch-icon" href="icons/icon-192.png"/>
<title>MI Flashcards</title>

<style>
/* ═══════════════════════════════════════════════════════════
   RESET & TOKENS
═══════════════════════════════════════════════════════════ */
*, *::before, *::after { box-sizing: border-box; margin: 0; padding: 0; }

:root {
  --bg:         #0b1120;
  --surface:    #111d38;
  --border:     #1e2e50;
  --gold:       #f5c518;
  --gold-dim:   #c49a10;
  --green:      #4ade80;
  --green-dim:  #1e4428;
  --text:       #e0e8f8;
  --muted:      #6677aa;
  --front-bg1:  #0d1f45;
  --front-bg2:  #162b60;
  --back-bg1:   #0e2210;
  --back-bg2:   #122a18;
  --radius:     20px;
  --safe-top:   env(safe-area-inset-top, 0px);
  --safe-bot:   env(safe-area-inset-bottom, 0px);
}

html, body {
  height: 100%;
  overflow: hidden; /* prevent scroll bounce on iOS */
}

body {
  background: var(--bg);
  font-family: -apple-system, 'Segoe UI', Arial, sans-serif;
  color: var(--text);
  display: flex;
  flex-direction: column;
  padding-top: var(--safe-top);
  padding-bottom: var(--safe-bot);
  touch-action: pan-y;
  user-select: none;
  -webkit-user-select: none;
}

/* ═══════════════════════════════════════════════════════════
   TOP BAR
═══════════════════════════════════════════════════════════ */
.topbar {
  flex-shrink: 0;
  display: flex;
  align-items: center;
  justify-content: space-between;
  padding: 12px 16px 8px;
  background: var(--bg);
  border-bottom: 1px solid var(--border);
}

.topbar-title {
  font-size: 1rem;
  font-weight: 700;
  color: #fff;
  letter-spacing: 0.5px;
  display: flex;
  align-items: center;
  gap: 6px;
}
.topbar-title .heart { color: #e74c3c; font-size: 1.1rem; }

.topbar-counter {
  font-size: 0.8rem;
  font-weight: 700;
  color: var(--gold);
  background: rgba(245,197,24,0.1);
  border: 1px solid rgba(245,197,24,0.25);
  border-radius: 8px;
  padding: 3px 10px;
}

/* ═══════════════════════════════════════════════════════════
   PROGRESS BAR
═══════════════════════════════════════════════════════════ */
.progress-track {
  flex-shrink: 0;
  height: 3px;
  background: var(--border);
}
.progress-fill {
  height: 100%;
  background: linear-gradient(90deg, var(--gold), #ff8c42);
  transition: width 0.4s ease;
  border-radius: 0 2px 2px 0;
}

/* ═══════════════════════════════════════════════════════════
   TOPIC LABEL
═══════════════════════════════════════════════════════════ */
.topic-row {
  flex-shrink: 0;
  display: flex;
  justify-content: center;
  padding: 8px 16px 4px;
}
.topic-pill {
  font-size: 0.7rem;
  font-weight: 700;
  letter-spacing: 1.5px;
  text-transform: uppercase;
  color: var(--gold);
  background: rgba(245,197,24,0.08);
  border: 1px solid rgba(245,197,24,0.2);
  border-radius: 20px;
  padding: 3px 14px;
}

/* ═══════════════════════════════════════════════════════════
   CARD SCENE
═══════════════════════════════════════════════════════════ */
.scene-wrap {
  flex: 1;
  display: flex;
  align-items: center;
  justify-content: center;
  padding: 8px 12px;
  overflow: hidden;
}

.scene {
  width: 100%;
  max-width: 560px;
  /* Maintain a good aspect ratio across screen sizes */
  aspect-ratio: 3 / 2.2;
  perspective: 1400px;
  cursor: pointer;
}

@media (max-height: 680px) {
  .scene { aspect-ratio: 3 / 1.9; }
}

.card {
  width: 100%;
  height: 100%;
  position: relative;
  transform-style: preserve-3d;
  transition: transform 0.6s cubic-bezier(0.35, 0.1, 0.15, 1);
  border-radius: var(--radius);
}
.card.flipped { transform: rotateY(180deg); }

.face {
  position: absolute;
  inset: 0;
  border-radius: var(--radius);
  backface-visibility: hidden;
  -webkit-backface-visibility: hidden;
  overflow: hidden;
  display: flex;
  flex-direction: column;
}

/* ── Front ── */
.face-front {
  background: linear-gradient(145deg, var(--front-bg1) 0%, var(--front-bg2) 100%);
  border: 1.5px solid #2a3f72;
  box-shadow: 0 12px 48px rgba(0,0,0,0.6);
  align-items: center;
  justify-content: center;
  text-align: center;
  padding: 24px 28px 16px;
  gap: 0;
}

.front-hint-top {
  position: absolute;
  top: 14px; right: 16px;
  font-size: 0.65rem;
  color: rgba(255,255,255,0.2);
  display: flex;
  align-items: center;
  gap: 4px;
}

.front-q-label {
  font-size: 0.62rem;
  font-weight: 700;
  letter-spacing: 2px;
  text-transform: uppercase;
  color: var(--muted);
  margin-bottom: 14px;
}

.front-question {
  font-size: clamp(1rem, 3.5vw, 1.45rem);
  font-weight: 700;
  color: #fff;
  line-height: 1.45;
  max-width: 420px;
}

.front-sub {
  margin-top: 16px;
  font-size: 0.72rem;
  color: #445577;
  font-style: italic;
  max-width: 380px;
}

.tap-indicator {
  position: absolute;
  bottom: 14px;
  left: 50%;
  transform: translateX(-50%);
  display: flex;
  align-items: center;
  gap: 5px;
  font-size: 0.65rem;
  color: rgba(255,255,255,0.18);
}

/* ── Back ── */
.face-back {
  background: linear-gradient(145deg, var(--back-bg1) 0%, var(--back-bg2) 100%);
  border: 1.5px solid #1e4428;
  box-shadow: 0 12px 48px rgba(0,0,0,0.6);
  transform: rotateY(180deg);
  padding: 16px 20px 12px;
  overflow: hidden;
}

.back-top {
  flex-shrink: 0;
  display: flex;
  align-items: center;
  gap: 8px;
  margin-bottom: 10px;
  border-bottom: 1px solid var(--green-dim);
  padding-bottom: 8px;
}
.back-badge {
  font-size: 0.65rem;
  font-weight: 700;
  letter-spacing: 1.5px;
  text-transform: uppercase;
  background: var(--green-dim);
  color: var(--green);
  border-radius: 6px;
  padding: 2px 8px;
}
.back-heading {
  font-size: 0.78rem;
  font-weight: 700;
  color: var(--green);
}

.back-scroll {
  flex: 1;
  overflow-y: auto;
  -webkit-overflow-scrolling: touch;
  overscroll-behavior: contain;
}
.back-scroll::-webkit-scrollbar { display: none; }

.answer-body {
  font-size: clamp(0.7rem, 2.2vw, 0.82rem);
  line-height: 1.7;
  color: #b8d8c0;
}

.section { margin-bottom: 9px; }
.section-title {
  font-size: 0.65rem;
  font-weight: 700;
  letter-spacing: 1.2px;
  text-transform: uppercase;
  color: #86efac;
  margin-bottom: 3px;
}
.answer-body ul { list-style: none; padding: 0; }
.answer-body ul li {
  padding-left: 14px;
  position: relative;
  margin-bottom: 2px;
}
.answer-body ul li::before {
  content: '▸';
  position: absolute;
  left: 0;
  color: var(--green);
  font-size: 0.65rem;
  top: 3px;
}
.highlight { color: #fde68a; font-weight: 700; }

.back-source {
  flex-shrink: 0;
  font-size: 0.62rem;
  color: #2a5235;
  font-style: italic;
  margin-top: 6px;
  padding-top: 6px;
  border-top: 1px solid var(--green-dim);
}

/* ═══════════════════════════════════════════════════════════
   SWIPE HINT (mobile, shown once)
═══════════════════════════════════════════════════════════ */
.swipe-hint {
  flex-shrink: 0;
  text-align: center;
  font-size: 0.65rem;
  color: var(--muted);
  padding: 2px 0 4px;
  opacity: 1;
  transition: opacity 0.5s;
}
.swipe-hint.hidden { opacity: 0; pointer-events: none; }

/* ═══════════════════════════════════════════════════════════
   BOTTOM CONTROLS
═══════════════════════════════════════════════════════════ */
.controls {
  flex-shrink: 0;
  padding: 8px 16px 10px;
  display: flex;
  gap: 8px;
  align-items: center;
}

.btn {
  border: none;
  border-radius: 12px;
  font-size: 0.82rem;
  font-weight: 700;
  cursor: pointer;
  padding: 12px 0;
  transition: all 0.15s;
  -webkit-tap-highlight-color: transparent;
  touch-action: manipulation;
}
.btn:active { transform: scale(0.95); }

.btn-nav {
  flex: 1;
  background: var(--surface);
  color: var(--text);
  border: 1px solid var(--border);
}
.btn-nav:disabled { opacity: 0.25; cursor: default; transform: none; }

.btn-flip {
  flex: 2;
  background: linear-gradient(135deg, var(--gold) 0%, #e0a800 100%);
  color: #0b1120;
  box-shadow: 0 4px 14px rgba(245,197,24,0.3);
  font-size: 0.88rem;
}
.btn-flip:active { box-shadow: none; }

.btn-shuffle {
  width: 44px;
  padding: 12px 0;
  background: var(--surface);
  color: var(--muted);
  border: 1px solid var(--border);
  font-size: 1rem;
  flex-shrink: 0;
}

/* ═══════════════════════════════════════════════════════════
   DOT INDICATORS
═══════════════════════════════════════════════════════════ */
.dots-row {
  flex-shrink: 0;
  display: flex;
  gap: 6px;
  justify-content: center;
  padding: 2px 16px 10px;
  flex-wrap: wrap;
}
.dot {
  width: 8px; height: 8px;
  border-radius: 50%;
  background: var(--border);
  border: 1.5px solid #2a3f70;
  cursor: pointer;
  transition: all 0.2s;
  -webkit-tap-highlight-color: transparent;
  touch-action: manipulation;
}
.dot.active { background: var(--gold); border-color: var(--gold); transform: scale(1.4); }
.dot.seen   { background: var(--green-dim); border-color: var(--green); }

/* ═══════════════════════════════════════════════════════════
   INSTALL BANNER
═══════════════════════════════════════════════════════════ */
.install-banner {
  position: fixed;
  bottom: calc(var(--safe-bot) + 12px);
  left: 12px; right: 12px;
  background: #162b60;
  border: 1px solid var(--gold);
  border-radius: 14px;
  padding: 12px 16px;
  display: flex;
  align-items: center;
  gap: 12px;
  box-shadow: 0 8px 30px rgba(0,0,0,0.5);
  z-index: 100;
  transform: translateY(120%);
  transition: transform 0.4s cubic-bezier(0.34, 1.56, 0.64, 1);
}
.install-banner.visible { transform: translateY(0); }

.install-icon { font-size: 1.5rem; flex-shrink: 0; }
.install-text { flex: 1; }
.install-text strong { display: block; font-size: 0.82rem; color: #fff; }
.install-text span   { font-size: 0.72rem; color: var(--muted); }

.btn-install {
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/* ═══════════════════════════════════════════════════════════
   RESPONSIVE TWEAKS
═══════════════════════════════════════════════════════════ */
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</head>
<body>

<!-- TOP BAR -->
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  <div class="topbar-title"><span class="heart">♥</span> MI Flashcards</div>
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<script>
/* ═══════════════════════════════════════════════════════════
   CARD DATA
═══════════════════════════════════════════════════════════ */
const CARDS = [
  {
    topic: "Pathophysiology",
    question: "What is the pathophysiology of myocardial infarction?",
    hint: "Plaque → Thrombus → Necrosis zones",
    heading: "Pathophysiology",
    body: `
      <div class="section"><div class="section-title">Core Mechanism</div><ul>
        <li>Atherosclerotic plaque <span class="highlight">rupture or erosion</span> → platelet aggregation → thrombus formation</li>
        <li>Complete occlusion → ischaemia → irreversible necrosis from <span class="highlight">20–40 min</span></li>
        <li>Wavefront: subendocardium first → transmural over 3–6 h</li>
      </ul></div>
      <div class="section"><div class="section-title">Zones (ECG correlate)</div><ul>
        <li><span class="highlight">Necrosis</span> → Q wave &nbsp;|&nbsp; <span class="highlight">Injury</span> → ST elevation &nbsp;|&nbsp; <span class="highlight">Ischaemia</span> → T inversion</li>
      </ul></div>
      <div class="section"><div class="section-title">MI Classification</div><ul>
        <li><span class="highlight">Type 1:</span> Spontaneous plaque rupture/erosion</li>
        <li><span class="highlight">Type 2:</span> Supply-demand mismatch (spasm, anaemia, tachycardia)</li>
        <li>Types 3–5: Cardiac death, PCI-related, CABG-related</li>
      </ul></div>`,
    source: "Harrison's 22E · Fuster & Hurst 15E · Robbins Pathology"
  },
  {
    topic: "ECG Diagnosis",
    question: "ECG criteria for STEMI vs NSTEMI — thresholds and evolution?",
    hint: "Leads V2-V3 have higher thresholds; earliest change = hyperacute T",
    heading: "ECG Criteria & Evolution",
    body: `
      <div class="section"><div class="section-title">STEMI — J-point elevation, 2 contiguous leads</div><ul>
        <li>All leads (except V2–V3): <span class="highlight">≥ 0.1 mV</span></li>
        <li>V2–V3: men ≥ 40 y → <span class="highlight">≥ 0.2 mV</span> &nbsp;|&nbsp; men &lt; 40 y → ≥ 0.25 mV &nbsp;|&nbsp; women → ≥ 0.15 mV</li>
        <li>New LBBB in ischaemic context = STEMI equivalent</li>
      </ul></div>
      <div class="section"><div class="section-title">ECG Evolution (STEMI)</div><ul>
        <li>Minutes: <span class="highlight">Hyperacute T-waves</span> (tall, broad, symmetric)</li>
        <li>Hours: ST elevation + early Q waves &nbsp;|&nbsp; Days: T inversion, Q deepen</li>
      </ul></div>
      <div class="section"><div class="section-title">NSTEMI / UA</div><ul>
        <li>ST depression ≥ 0.5 mm or T inversion + <span class="highlight">elevated troponin</span> = NSTEMI</li>
        <li>Same ECG but troponin <span class="highlight">negative</span> = Unstable Angina</li>
      </ul></div>
      <div class="section"><div class="section-title">Lead Groups</div><ul>
        <li>Inferior: II, III, aVF &nbsp;|&nbsp; Anterior: V1–V4 &nbsp;|&nbsp; Lateral: I, aVL, V5–V6</li>
        <li>Posterior: ST depression V1–V3 → confirm with V7–V9 &nbsp;|&nbsp; RV: V4R</li>
      </ul></div>`,
    source: "Frameworks for Internal Medicine · Harrison's 22E"
  },
  {
    topic: "Biomarkers",
    question: "Cardiac biomarker kinetics in MI — rise, peak, normalise times?",
    hint: "hs-cTn is gold standard; CK-MB detects reinfarction",
    heading: "Biomarker Kinetics",
    body: `
      <div class="section"><div class="section-title">hs-Troponin I/T — Gold Standard</div><ul>
        <li>Rise: <span class="highlight">1–3 h</span> &nbsp;|&nbsp; Peak: 12–24 h &nbsp;|&nbsp; Normalise: 7–14 days</li>
        <li>Delta rise <span class="highlight">≥ 20%</span> at 1–2 h = diagnose MI (0h/1h or 0h/2h protocol)</li>
      </ul></div>
      <div class="section"><div class="section-title">CK-MB</div><ul>
        <li>Rise: 3–4 h &nbsp;|&nbsp; Peak: 18–24 h &nbsp;|&nbsp; Normalise: <span class="highlight">48–72 h</span></li>
        <li>Use for: detecting <span class="highlight">reinfarction</span> (normalises faster than troponin)</li>
      </ul></div>
      <div class="section"><div class="section-title">Myoglobin</div><ul>
        <li>Rise: <span class="highlight">1–2 h</span> (earliest) &nbsp;|&nbsp; Peak: 6–9 h &nbsp;|&nbsp; Normalise: 24 h</li>
        <li>Non-specific — elevated in skeletal muscle injury too</li>
      </ul></div>
      <div class="section"><div class="section-title">Non-MI Troponin Rise (Type 2)</div><ul>
        <li>PE, myocarditis, sepsis, AKI, HF, stroke, cardioversion</li>
      </ul></div>`,
    source: "Tietz Lab Medicine 7E · Goldman-Cecil"
  },
  {
    topic: "STEMI Management",
    question: "Time targets and reperfusion strategy for STEMI?",
    hint: "D2B ≤ 90 min; D2N ≤ 30 min; FMC→ECG ≤ 10 min",
    heading: "Acute STEMI Management",
    body: `
      <div class="section"><div class="section-title">Time Targets</div><ul>
        <li>FMC → ECG: <span class="highlight">≤ 10 min</span></li>
        <li>Door-to-balloon (primary PCI): <span class="highlight">≤ 90 min</span></li>
        <li>Door-to-needle (fibrinolysis): <span class="highlight">≤ 30 min</span></li>
        <li>FMC-to-device if transferred: <span class="highlight">≤ 120 min</span></li>
      </ul></div>
      <div class="section"><div class="section-title">Reperfusion Choice</div><ul>
        <li>Primary PCI preferred if skilled lab within 90–120 min</li>
        <li>Fibrinolysis (alteplase/tenecteplase) if PCI unavailable in time</li>
        <li>Absolute CI fibrinolysis: prior ICH, active bleed, aortic dissection</li>
      </ul></div>
      <div class="section"><div class="section-title">Initial Drug Therapy (MONA-B)</div><ul>
        <li><span class="highlight">M</span>orphine · <span class="highlight">O</span>xygen (SpO₂ &lt; 90% only) · <span class="highlight">N</span>itrates</li>
        <li><span class="highlight">A</span>spirin 300 mg + P2Y12 load · <span class="highlight">B</span>eta-blocker + Heparin</li>
        <li>High-intensity <span class="highlight">statin</span> before discharge</li>
      </ul></div>`,
    source: "Tintinalli EM · Fuster & Hurst 15E · Harrison's 22E"
  },
  {
    topic: "Antithrombotic Therapy",
    question: "DAPT and anticoagulation regimen in ACS — agents and duration?",
    hint: "Ticagrelor > Prasugrel > Clopidogrel; DAPT = 12 months",
    heading: "Antithrombotic Therapy",
    body: `
      <div class="section"><div class="section-title">DAPT Loading Doses</div><ul>
        <li>Aspirin 162–325 mg → 75–100 mg daily (indefinite)</li>
        <li><span class="highlight">Ticagrelor</span> 180 mg — preferred (PLATO: ↓ CV death vs clopidogrel)</li>
        <li><span class="highlight">Prasugrel</span> 60 mg — STEMI + PCI (avoid: prior TIA/stroke, ≥ 75 y, &lt; 60 kg)</li>
        <li><span class="highlight">Clopidogrel</span> 600 mg — if above unavailable or triple therapy</li>
        <li>DAPT duration: <span class="highlight">12 months</span> post-ACS</li>
      </ul></div>
      <div class="section"><div class="section-title">Anticoagulation</div><ul>
        <li>UFH IV — STEMI PCI (easy reversal with protamine)</li>
        <li>Enoxaparin 1 mg/kg SC q12h — NSTEMI</li>
        <li>Fondaparinux 2.5 mg SC — NSTEMI conservative (lowest bleed risk)</li>
        <li>Bivalirudin — direct thrombin inhibitor; PCI alternative</li>
      </ul></div>`,
    source: "Harrison's 22E · Fuster & Hurst 15E · ESC ACS 2023"
  },
  {
    topic: "Complications",
    question: "Major complications of MI — Killip, mechanical, and electrical?",
    hint: "Mechanical: days 3–7; Dressler's: 2–10 weeks; Killip IV = 81% mortality",
    heading: "MI Complications",
    body: `
      <div class="section"><div class="section-title">Killip Classification</div><ul>
        <li>I: No HF — <span class="highlight">6%</span> &nbsp;|&nbsp; II: S3/rales — <span class="highlight">17%</span></li>
        <li>III: Pulmonary oedema — <span class="highlight">38%</span> &nbsp;|&nbsp; IV: Cardiogenic shock — <span class="highlight">81%</span></li>
      </ul></div>
      <div class="section"><div class="section-title">Mechanical (days 3–7)</div><ul>
        <li><span class="highlight">Free wall rupture</span> → tamponade → PEA (surgical emergency)</li>
        <li><span class="highlight">Papillary muscle rupture</span> → acute MR, flash pulmonary oedema</li>
        <li><span class="highlight">VSD</span> → left-to-right shunt; step-up O₂ sat in RV; echo confirms</li>
      </ul></div>
      <div class="section"><div class="section-title">Electrical</div><ul>
        <li>VF/VT — #1 pre-hospital death; defibrillate immediately</li>
        <li>Complete heart block (inferior MI) → atropine / temporary pacing</li>
        <li>AIVR — reperfusion arrhythmia; benign, no treatment needed</li>
      </ul></div>
      <div class="section"><div class="section-title">Late</div><ul>
        <li><span class="highlight">Dressler's syndrome</span> (2–10 wk): immune pericarditis → aspirin/colchicine</li>
        <li><span class="highlight">LV thrombus</span> (anterior STEMI) → anticoagulate 3–6 months</li>
      </ul></div>`,
    source: "Goldman-Cecil · Robbins Pathology · Harrison's 22E"
  },
  {
    topic: "Coronary Territories",
    question: "Which artery, which territory, which ECG leads — and clinical correlates?",
    hint: "LAD=anterior; RCA=inferior+AV node; LCX=lateral/posterior",
    heading: "Coronary Territories",
    body: `
      <div class="section"><div class="section-title">LAD (Left Anterior Descending)</div><ul>
        <li>Wall: anterior, septum, apex, anterior papillary</li>
        <li>Leads: <span class="highlight">V1–V4</span></li>
        <li>Risks: large MI, new LBBB, cardiogenic shock, apical thrombus</li>
      </ul></div>
      <div class="section"><div class="section-title">RCA (Right Coronary)</div><ul>
        <li>Wall: inferior, RV free wall, SA node (60%), AV node (90%)</li>
        <li>Leads: <span class="highlight">II, III, aVF</span>; RV MI → V4R</li>
        <li><span class="highlight">RV MI triad:</span> hypotension + raised JVP + clear lungs (no diuretics/nitrates!)</li>
      </ul></div>
      <div class="section"><div class="section-title">LCX (Left Circumflex)</div><ul>
        <li>Wall: lateral, posterior (dominant LCx)</li>
        <li>Leads: <span class="highlight">I, aVL, V5–V6</span>; posterior → ST depression V1–V3, confirm V7–V9</li>
        <li>Often "electrically silent" on standard 12-lead</li>
      </ul></div>`,
    source: "Fuster & Hurst 15E · Harrison's 22E"
  },
  {
    topic: "Secondary Prevention",
    question: "Secondary prevention medications, targets, and device criteria after MI?",
    hint: "Quadruplet GDMT + statin; LDL < 55 mg/dL; ICD if EF ≤ 35%",
    heading: "Secondary Prevention",
    body: `
      <div class="section"><div class="section-title">Mandatory Medications</div><ul>
        <li><span class="highlight">Aspirin</span> 75–100 mg — indefinite</li>
        <li><span class="highlight">P2Y12</span> (ticagrelor/clopidogrel) — 12 months</li>
        <li><span class="highlight">High-intensity statin</span> — atorvastatin 40–80 mg or rosuvastatin 20–40 mg</li>
        <li><span class="highlight">Beta-blocker</span> — all with LVEF ≤ 40% for ≥ 3 years</li>
        <li><span class="highlight">ACEi / ARB</span> — if LVEF ≤ 40%, DM, or HTN (indefinite)</li>
      </ul></div>
      <div class="section"><div class="section-title">If LVEF ≤ 40%</div><ul>
        <li><span class="highlight">MRA</span> (eplerenone/spironolactone) + <span class="highlight">SGLT2i</span> (dapagliflozin)</li>
      </ul></div>
      <div class="section"><div class="section-title">Targets</div><ul>
        <li>LDL: <span class="highlight">&lt; 55 mg/dL</span> (ESC) / &lt; 70 (ACC) — add ezetimibe or PCSK9i if needed</li>
        <li>BP &lt; 130/80 &nbsp;|&nbsp; HbA1c &lt; 7% &nbsp;|&nbsp; Smoking cessation &nbsp;|&nbsp; Cardiac rehab</li>
      </ul></div>
      <div class="section"><div class="section-title">Device (ICD)</div><ul>
        <li>LVEF ≤ 35% + ≥ 40 days post-MI + optimal GDMT ≥ 3 months + life expectancy &gt; 1 yr</li>
      </ul></div>`,
    source: "Harrison's 22E · ESC ACS Guidelines 2023 · Fuster & Hurst 15E"
  }
];

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</html>

Running Command

# Validate all files exist and run a quick sanity check on the HTML python3 << 'PYEOF' import os, json base = '/tmp/workspace/mi-pwa' files = { 'index.html': os.path.join(base, 'index.html'), 'sw.js': os.path.join(base, 'sw.js'), 'manifest.json': os.path.join(base, 'manifest.json'), 'icon-192.png': os.path.join(base, 'icons/icon-192.png'), 'icon-512.png': os.path.join(base, 'icons/icon-512.png'), } print("File checks:") for name, path in files.items(): size = os.path.getsize(path) print(f" ✓ {name:20s} {size:>8,} bytes") # Validate manifest JSON with open(files['manifest.json']) as f: m = json.load(f) print(f"\nManifest: name='{m['name']}', display='{m['display']}', icons={len(m['icons'])}") # HTML checks with open(files['index.html']) as f: html = f.read() checks = [ ('SW registration', "serviceWorker.register('./sw.js')" in html), ('manifest link', 'manifest.json' in html), ('apple-touch-icon', 'apple-touch-icon' in html), ('theme-color', 'theme-color' in html), ('viewport-fit=cover', 'viewport-fit=cover' in html), ('safe-area-inset', 'safe-area-inset' in html), ('Touch swipe', 'touchstart' in html and 'touchend' in html), ('Flip animation', 'rotateY(180deg)' in html), ('Install banner', 'installBanner' in html), ('8 CARDS', html.count("topic:") == 8), ('Keyboard nav', 'ArrowRight' in html), ('Shuffle', 'shuffleCards' in html), ] print("\nHTML checks:") for label, ok in checks: print(f" {'✓' if ok else '✗'} {label}") PYEOF # Zip it up cd /tmp/workspace && python3 -c " import zipfile, os base = '/tmp/workspace/mi-pwa' zpath = '/tmp/workspace/MI_Flashcards_PWA.zip' with zipfile.ZipFile(zpath, 'w', zipfile.ZIP_DEFLATED) as zf: for root, dirs, files in os.walk(base): for fname in files: full = os.path.join(root, fname) arc = os.path.relpath(full, base) zf.write(full, arc) print(f' + {arc}') print(f'ZIP size: {os.path.getsize(zpath):,} bytes') "

Your PWA is ready. Download the ZIP:

MI Flashcards PWA

Archive · ZIP

Or grab just the main file:

index

HTML File · HTML

How to install on your phone

Android (Chrome):

Unzip the folder and serve it locally, OR host on any web server (GitHub Pages, Netlify, etc.)
Open in Chrome → tap the ⋮ menu → "Add to Home screen"
The app installs like a native app - full screen, no browser bar

iPhone (Safari):

Host the folder on any HTTPS server
Open in Safari → tap Share → "Add to Home Screen"
It appears on your home screen with the heart icon

Quick local test (your computer):

cd /path/to/mi-pwa
python3 -m http.server 8080
# then open http://localhost:8080 in Chrome

What's in the PWA

File	Purpose
`index.html`	Full app - cards, flip animation, swipe, install prompt
`sw.js`	Service worker - caches everything for offline use
`manifest.json`	App metadata - name, icon, theme, standalone mode
`icons/`	App icons (192px + 512px) for home screen

Interactions

Gesture / Key	Action
Tap card or `Space`	Flip to reveal answer
Swipe left/right on card	Next / prev card
`←` `→` arrow keys	Navigate
`S`	Shuffle deck
Dot at bottom	Jump to any card
Green dots	Cards you've already seen

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