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

# ── Colour palette ──────────────────────────────────────────────
NAVY       = HexColor('#1A3A5C')
TEAL       = HexColor('#006B6B')
GOLD       = HexColor('#C8860A')
LIGHT_BLUE = HexColor('#D6EAF8')
LIGHT_TEAL = HexColor('#D0EFEF')
LIGHT_GOLD = HexColor('#FEF9E7')
WHITE      = colors.white
GREY_BG    = HexColor('#F4F6F7')
RED_ALERT  = HexColor('#C0392B')
GREEN_OK   = HexColor('#1E8449')
ORANGE     = HexColor('#D35400')
LIGHT_RED  = HexColor('#FADBD8')
DARK_GREY  = HexColor('#2C3E50')

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

def make_style(name, parent='Normal', **kwargs):
    return ParagraphStyle(name, parent=styles[parent], **kwargs)

cover_title   = make_style('CoverTitle',   fontSize=32, textColor=WHITE,
                            alignment=TA_CENTER, fontName='Helvetica-Bold', leading=40)
cover_sub     = make_style('CoverSub',     fontSize=16, textColor=HexColor('#BDC3C7'),
                            alignment=TA_CENTER, fontName='Helvetica', leading=22)
cover_tag     = make_style('CoverTag',     fontSize=11, textColor=GOLD,
                            alignment=TA_CENTER, fontName='Helvetica-Bold')

chapter_title = make_style('ChapterTitle', fontSize=22, textColor=WHITE,
                            fontName='Helvetica-Bold', leading=28)
section_head  = make_style('SectionHead',  fontSize=14, textColor=NAVY,
                            fontName='Helvetica-Bold', leading=18, spaceAfter=4)
sub_head      = make_style('SubHead',      fontSize=11, textColor=TEAL,
                            fontName='Helvetica-Bold', leading=14, spaceAfter=3)
body_text     = make_style('BodyText2',    fontSize=9.5, textColor=DARK_GREY,
                            fontName='Helvetica', leading=13, spaceAfter=3)
bullet_style  = make_style('Bullet2',      fontSize=9.5, textColor=DARK_GREY,
                            fontName='Helvetica', leading=13, leftIndent=14,
                            bulletIndent=4, spaceAfter=2)
alert_style   = make_style('Alert',        fontSize=9.5, textColor=RED_ALERT,
                            fontName='Helvetica-Bold', leading=13,
                            leftIndent=10, spaceAfter=2)
tip_style     = make_style('Tip',          fontSize=9.5, textColor=GREEN_OK,
                            fontName='Helvetica-Bold', leading=13,
                            leftIndent=10, spaceAfter=2)
table_hdr     = make_style('TableHdr',     fontSize=9, textColor=WHITE,
                            fontName='Helvetica-Bold', alignment=TA_CENTER)
table_cell    = make_style('TableCell',    fontSize=8.5, textColor=DARK_GREY,
                            fontName='Helvetica', leading=12)
footer_style  = make_style('Footer',       fontSize=8, textColor=HexColor('#7F8C8D'),
                            alignment=TA_CENTER)

PAGE_W, PAGE_H = A4

# ── Helper builders ──────────────────────────────────────────────
def hline(color=TEAL, thickness=1):
    return HRFlowable(width='100%', thickness=thickness, color=color, spaceAfter=6, spaceBefore=4)

def chapter_banner(title, subtitle='', color=NAVY):
    data = [[Paragraph(title, chapter_title)],
            [Paragraph(subtitle, make_style('CSubtitle', fontSize=10, textColor=HexColor('#BDC3C7'),
                                             fontName='Helvetica'))]]
    t = Table(data, colWidths=[17*cm])
    t.setStyle(TableStyle([
        ('BACKGROUND', (0,0), (-1,-1), color),
        ('ROUNDEDCORNERS', [6]),
        ('TOPPADDING',    (0,0), (-1,-1), 12),
        ('BOTTOMPADDING', (0,0), (-1,-1), 12),
        ('LEFTPADDING',   (0,0), (-1,-1), 16),
    ]))
    return t

def info_table(headers, rows, col_widths=None, header_color=NAVY):
    if col_widths is None:
        n = len(headers)
        col_widths = [17*cm/n]*n
    header_row = [Paragraph(h, table_hdr) for h in headers]
    table_data = [header_row]
    for row in rows:
        table_data.append([Paragraph(str(c), table_cell) for c in row])
    t = Table(table_data, colWidths=col_widths)
    ts = TableStyle([
        ('BACKGROUND',    (0,0), (-1,0),  header_color),
        ('ROWBACKGROUNDS',(0,1), (-1,-1), [WHITE, GREY_BG]),
        ('GRID',          (0,0), (-1,-1), 0.4, HexColor('#BDC3C7')),
        ('VALIGN',        (0,0), (-1,-1), 'TOP'),
        ('TOPPADDING',    (0,0), (-1,-1), 5),
        ('BOTTOMPADDING', (0,0), (-1,-1), 5),
        ('LEFTPADDING',   (0,0), (-1,-1), 6),
        ('RIGHTPADDING',  (0,0), (-1,-1), 6),
        ('ROUNDEDCORNERS',[4]),
    ])
    t.setStyle(ts)
    return t

def alert_box(text, bg=LIGHT_RED, border=RED_ALERT, label='RED FLAG'):
    data = [[Paragraph(f'<b>{label}:</b> {text}',
                        make_style('AlertBox', fontSize=9, textColor=RED_ALERT,
                                   fontName='Helvetica-Bold', leading=12))]]
    t = Table(data, colWidths=[17*cm])
    t.setStyle(TableStyle([
        ('BACKGROUND',    (0,0),(-1,-1), bg),
        ('LEFTBORDERPADDING', (0,0), (-1,-1), 4),
        ('BOX',           (0,0),(-1,-1), 1.5, border),
        ('TOPPADDING',    (0,0),(-1,-1), 7),
        ('BOTTOMPADDING', (0,0),(-1,-1), 7),
        ('LEFTPADDING',   (0,0),(-1,-1), 10),
        ('ROUNDEDCORNERS',[4]),
    ]))
    return t

def tip_box(text, bg=LIGHT_TEAL, border=TEAL, label='AMC TIP'):
    data = [[Paragraph(f'<b>{label}:</b> {text}',
                        make_style('TipBox', fontSize=9, textColor=TEAL,
                                   fontName='Helvetica-Bold', leading=12))]]
    t = Table(data, colWidths=[17*cm])
    t.setStyle(TableStyle([
        ('BACKGROUND',    (0,0),(-1,-1), bg),
        ('BOX',           (0,0),(-1,-1), 1.5, border),
        ('TOPPADDING',    (0,0),(-1,-1), 7),
        ('BOTTOMPADDING', (0,0),(-1,-1), 7),
        ('LEFTPADDING',   (0,0),(-1,-1), 10),
        ('ROUNDEDCORNERS',[4]),
    ]))
    return t

def bullet(text):
    return Paragraph(f'• {text}', bullet_style)

def sp(n=6):
    return Spacer(1, n)

# ── Page header/footer ───────────────────────────────────────────
def on_page(canvas, doc):
    canvas.saveState()
    # Header bar
    canvas.setFillColor(NAVY)
    canvas.rect(0, PAGE_H-1.2*cm, PAGE_W, 1.2*cm, fill=1, stroke=0)
    canvas.setFillColor(WHITE)
    canvas.setFont('Helvetica-Bold', 9)
    canvas.drawString(1.5*cm, PAGE_H-0.8*cm, 'AMC MCQ Quick Reference Guide')
    canvas.setFont('Helvetica', 9)
    canvas.drawRightString(PAGE_W-1.5*cm, PAGE_H-0.8*cm, f'Page {doc.page}')
    # Footer
    canvas.setFillColor(HexColor('#7F8C8D'))
    canvas.setFont('Helvetica', 7.5)
    canvas.drawCentredString(PAGE_W/2, 0.7*cm,
        'For AMC MCQ Exam Preparation | Based on Australian Clinical Guidelines | Updated 2025-26')
    canvas.restoreState()

# ── Document setup ───────────────────────────────────────────────
OUTPUT = '/home/daytona/workspace/amc-guidelines/AMC_Guidelines_Quick_Reference.pdf'
doc = SimpleDocTemplate(
    OUTPUT,
    pagesize=A4,
    topMargin=1.8*cm, bottomMargin=1.5*cm,
    leftMargin=1.8*cm, rightMargin=1.8*cm,
    title='AMC MCQ Quick Reference Guide',
    author='Orris Medical AI',
)

story = []

# ════════════════════════════════════════════════════════════════
# COVER PAGE
# ════════════════════════════════════════════════════════════════
cover_bg = Table([['']], colWidths=[17*cm], rowHeights=[24*cm])
cover_bg.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,-1),NAVY)]))
story.append(cover_bg)

# Overlay content on cover via nested table
cover_content = [
    [Paragraph('AMC MCQ', make_style('CT1', fontSize=48, textColor=GOLD,
                                      fontName='Helvetica-Bold', alignment=TA_CENTER))],
    [Paragraph('Quick Reference Guide', make_style('CT2', fontSize=26, textColor=WHITE,
                                                    fontName='Helvetica-Bold', alignment=TA_CENTER))],
    [Spacer(1, 0.5*cm)],
    [Paragraph('Australian Medical Council', make_style('CT3', fontSize=14, textColor=HexColor('#BDC3C7'),
                                                          fontName='Helvetica', alignment=TA_CENTER))],
    [Paragraph('All Clinical Disciplines | Exam-Ready Format', make_style('CT4', fontSize=11,
               textColor=GOLD, fontName='Helvetica-Bold', alignment=TA_CENTER))],
    [Spacer(1, 1*cm)],
    [Table([[
        Paragraph('150 MCQs', make_style('stat', fontSize=11, textColor=WHITE, fontName='Helvetica-Bold', alignment=TA_CENTER)),
        Paragraph('3.5 Hours', make_style('stat', fontSize=11, textColor=WHITE, fontName='Helvetica-Bold', alignment=TA_CENTER)),
        Paragraph('Pass: 250/500', make_style('stat', fontSize=11, textColor=WHITE, fontName='Helvetica-Bold', alignment=TA_CENTER)),
        Paragraph('6 Specialties', make_style('stat', fontSize=11, textColor=WHITE, fontName='Helvetica-Bold', alignment=TA_CENTER)),
    ]], colWidths=[4.25*cm]*4,
    style=TableStyle([
        ('BACKGROUND',(0,0),(-1,-1),TEAL),
        ('BOX',(0,0),(-1,-1),1,WHITE),
        ('LINEAFTER',(0,0),(2,0),0.5,WHITE),
        ('TOPPADDING',(0,0),(-1,-1),8),
        ('BOTTOMPADDING',(0,0),(-1,-1),8),
        ('ROUNDEDCORNERS',[6]),
    ]))],
    [Spacer(1, 1*cm)],
    [Paragraph('Medicine 30%  |  Surgery 20%  |  Paediatrics 12.5%',
               make_style('dist', fontSize=9, textColor=HexColor('#BDC3C7'),
                           fontName='Helvetica', alignment=TA_CENTER))],
    [Paragraph('O&G 12.5%  |  Mental Health 12.5%  |  Population Health 12.5%',
               make_style('dist2', fontSize=9, textColor=HexColor('#BDC3C7'),
                           fontName='Helvetica', alignment=TA_CENTER))],
]

# Replace cover_bg with a proper positioned cover
story = []  # reset
cover_tbl = Table(cover_content, colWidths=[17*cm])
cover_tbl.setStyle(TableStyle([
    ('BACKGROUND', (0,0),(-1,-1), NAVY),
    ('TOPPADDING', (0,0),(-1,-1), 8),
    ('BOTTOMPADDING',(0,0),(-1,-1), 8),
    ('LEFTPADDING',(0,0),(-1,-1), 10),
    ('RIGHTPADDING',(0,0),(-1,-1), 10),
    ('ALIGN',(0,0),(-1,-1),'CENTER'),
    ('VALIGN',(0,0),(-1,-1),'MIDDLE'),
]))
story.append(cover_tbl)
story.append(PageBreak())

# ════════════════════════════════════════════════════════════════
# TABLE OF CONTENTS (simple)
# ════════════════════════════════════════════════════════════════
story.append(chapter_banner('Table of Contents', 'AMC MCQ All Disciplines', TEAL))
story.append(sp(12))
toc_items = [
    ('1', 'INTERNAL MEDICINE', 'Cardiology, Endocrinology, Respiratory, Gastroenterology, Neurology, Renal, Haematology, Rheumatology', '4'),
    ('2', 'SURGERY', 'General Surgery, Orthopaedics, Urology, Vascular, Neurosurgery', '9'),
    ('3', 'PAEDIATRICS', 'Neonatal, GI Disorders, Respiratory, Growth & Development, Immunisation', '13'),
    ('4', 'OBSTETRICS & GYNAECOLOGY', 'Antenatal Care, Labour, Postpartum, Gynaecology, Contraception', '17'),
    ('5', 'MENTAL HEALTH & PSYCHIATRY', 'Mood Disorders, Psychosis, Anxiety, Substance Abuse, Child Psych', '21'),
    ('6', 'POPULATION HEALTH & EMERGENCY', 'Screening, Ethics, Emergency Algorithms, Public Health, Indigenous Health', '25'),
]
for num, title, subtitle, page in toc_items:
    row_data = [[
        Paragraph(f'<b>{num}</b>', make_style('tocnum', fontSize=14, textColor=NAVY,
                                               fontName='Helvetica-Bold', alignment=TA_CENTER)),
        Paragraph(f'<b>{title}</b><br/><font size="8" color="#5D6D7E">{subtitle}</font>',
                  make_style('toctitle', fontSize=11, textColor=DARK_GREY, fontName='Helvetica-Bold')),
        Paragraph(f'<b>p.{page}</b>', make_style('tocpg', fontSize=11, textColor=TEAL,
                                                   fontName='Helvetica-Bold', alignment=TA_CENTER)),
    ]]
    t = Table(row_data, colWidths=[1.5*cm, 13.5*cm, 2*cm])
    t.setStyle(TableStyle([
        ('BACKGROUND',(0,0),(-1,-1), LIGHT_BLUE),
        ('BOX',(0,0),(-1,-1),0.5,HexColor('#AED6F1')),
        ('LEFTPADDING',(0,0),(-1,-1),8),
        ('RIGHTPADDING',(0,0),(-1,-1),8),
        ('TOPPADDING',(0,0),(-1,-1),8),
        ('BOTTOMPADDING',(0,0),(-1,-1),8),
        ('VALIGN',(0,0),(-1,-1),'MIDDLE'),
        ('ROUNDEDCORNERS',[4]),
    ]))
    story.append(t)
    story.append(sp(5))

story.append(PageBreak())

# ════════════════════════════════════════════════════════════════
# CHAPTER 1: INTERNAL MEDICINE
# ════════════════════════════════════════════════════════════════
story.append(chapter_banner('Chapter 1: Internal Medicine',
    'Medicine constitutes 30% of the AMC MCQ blueprint', NAVY))
story.append(sp(10))

# ── Cardiology ──────────────────────────────────────────────────
story.append(KeepTogether([
    Paragraph('CARDIOLOGY', section_head),
    hline(),
]))

story.append(Paragraph('Acute Coronary Syndrome (ACS)', sub_head))
story.append(info_table(
    ['Feature', 'STEMI', 'NSTEMI / UA'],
    [
        ['ECG', 'ST elevation, new LBBB', 'ST depression, T-wave inversion or normal'],
        ['Troponin', 'Elevated', 'Elevated (NSTEMI) / Normal (UA)'],
        ['Immediate Rx', 'Primary PCI within 90 min', 'Anticoagulation + risk stratification'],
        ['Antiplatelet', 'Aspirin 300mg + P2Y12 inhibitor', 'Same'],
        ['Key drug', 'Morphine, O2, Nitrates, Aspirin (MONA)', 'MONA + heparin'],
    ],
    col_widths=[4*cm, 6.5*cm, 6.5*cm]
))
story.append(sp(4))
story.append(tip_box('AMC often tests: Do NOT give nitrates if systolic BP <90 mmHg or right ventricular infarct (inferior STEMI). Avoid in phosphodiesterase inhibitor users.'))
story.append(sp(6))

story.append(Paragraph('Heart Failure', sub_head))
story.append(info_table(
    ['Type', 'EF', 'Key Features', 'Treatment'],
    [
        ['HFrEF', '<40%', 'Dilated, systolic dysfunction', 'ACEi/ARB + Beta-blocker + MRA + SGLT2i'],
        ['HFpEF', '>50%', 'Preserved systolic, diastolic dysfunction', 'Diuretics, control comorbidities, SGLT2i'],
        ['Acute HF', 'Either', 'Pulmonary oedema, orthopnoea', 'O2, IV furosemide, GTN infusion, sit upright'],
    ],
    col_widths=[2.5*cm, 2*cm, 6*cm, 6.5*cm]
))
story.append(sp(4))
story.append(alert_box('Bilateral crackles + S3 gallop + raised JVP + pitting oedema = cardiac failure. Order CXR, BNP, echo.'))
story.append(sp(6))

story.append(Paragraph('Atrial Fibrillation (AF)', sub_head))
story.append(info_table(
    ['Scenario', 'Management'],
    [
        ['Haemodynamically unstable AF', 'Immediate DC cardioversion'],
        ['AF <48 hours, stable', 'Rate OR rhythm control; anticoagulate if CHADS2-VASc ≥1 (♂) / ≥2 (♀)'],
        ['AF >48 hours or unknown duration', 'Rate control + anticoagulate ≥3 weeks before cardioversion; TOE-guided if urgent'],
        ['Rate control drugs', 'Beta-blockers (first line), diltiazem, digoxin (if HF)'],
        ['Anticoagulation', 'DOAC (rivaroxaban, apixaban) preferred over warfarin in non-valvular AF'],
    ],
    col_widths=[5.5*cm, 11.5*cm]
))
story.append(sp(8))

# ── Endocrinology ───────────────────────────────────────────────
story.append(KeepTogether([
    Paragraph('ENDOCRINOLOGY', section_head),
    hline(),
]))

story.append(Paragraph('Diabetes Mellitus', sub_head))
story.append(info_table(
    ['Parameter', 'Normal', 'Pre-diabetes', 'Diabetes'],
    [
        ['Fasting glucose', '<5.6 mmol/L', '5.6-6.9 mmol/L', '≥7.0 mmol/L'],
        ['2hr OGTT', '<7.8 mmol/L', '7.8-11.0 mmol/L', '≥11.1 mmol/L'],
        ['HbA1c', '<5.7%', '5.7-6.4%', '≥6.5%'],
        ['Random glucose', '-', '-', '≥11.1 + symptoms'],
    ],
    col_widths=[4.5*cm, 3.5*cm, 4*cm, 5*cm]
))
story.append(sp(5))
story.append(info_table(
    ['Type', 'First-Line Rx', 'Key Drug Notes'],
    [
        ['T2DM', 'Metformin (unless GFR <30)', 'Add SGLT2i if CVD/HF; GLP1-RA if obesity; insulin if HbA1c uncontrolled'],
        ['T1DM', 'Insulin (basal-bolus)', 'CSII (pump) for selected patients; check for coeliac, thyroid disease'],
        ['DKA', 'IV fluids + insulin infusion + K+ replacement', 'K+ must be ≥3.5 before starting insulin; switch to SC when eating'],
        ['HHS', 'Slow IV fluid replacement, heparin prophylaxis', 'Avoid rapid correction; BG target 10-15 mmol/L initially'],
    ],
    col_widths=[2.5*cm, 6*cm, 8.5*cm]
))
story.append(sp(4))
story.append(tip_box('Antenatal OGTT at 24-28 weeks is Australian guideline standard. GDM target: fasting <5.0, 2hr <6.7 mmol/L. First-line is diet; metformin/insulin if not controlled.'))
story.append(sp(6))

story.append(Paragraph('Thyroid Disorders', sub_head))
story.append(info_table(
    ['Disorder', 'TSH', 'T4/T3', 'Symptoms', 'Treatment'],
    [
        ['Hypothyroidism', 'High', 'Low', 'Fatigue, weight gain, cold intolerance, constipation, bradycardia', 'Levothyroxine (thyroxine)'],
        ['Hyperthyroidism (Graves)', 'Low', 'High', 'Weight loss, heat intolerance, tremor, tachycardia, exophthalmos', 'Carbimazole/PTU; beta-blocker for symptoms; radioiodine/surgery'],
        ['Thyroid storm', 'Very low', 'Very high', 'Fever, AF, altered consciousness, severe tachycardia', 'ICU; PTU, iodine (Lugol\'s), hydrocortisone, propranolol'],
        ['Subclinical hypothyroid', 'High', 'Normal', 'Minimal or none', 'Treat if TSH >10, symptomatic, or pregnant'],
    ],
    col_widths=[3*cm, 1.5*cm, 1.5*cm, 6*cm, 5*cm]
))
story.append(sp(8))

# ── Respiratory ─────────────────────────────────────────────────
story.append(KeepTogether([
    Paragraph('RESPIRATORY', section_head),
    hline(),
]))

story.append(info_table(
    ['Condition', 'Key Presentation', 'Investigation', 'Management'],
    [
        ['Asthma', 'Wheeze, SOB, chest tightness; reversible airflow obstruction', 'Spirometry: FEV1/FVC <0.7, reversible with bronchodilator', 'SABA PRN; add ICS; LABA + ICS; biologics for severe. Avoid NSAIDs/aspirin if sensitive.'],
        ['COPD', 'Smoker, chronic productive cough, progressive dyspnoea; FEV1/FVC <0.7 post-BD NOT reversible', 'Spirometry (post-bronchodilator), CXR, ABG', 'SABA + SAMA; LABA+LAMA; add ICS if frequent exacerbations; pulm rehab; O2 if pO2 <55 mmHg'],
        ['Pneumonia (CAP)', 'Fever, productive cough, consolidation on CXR', 'CXR, sputum, FBC, CRP; CURB-65 score', 'CURB-65 0-1: oral amoxicillin; ≥2: admit; ≥3: IV amox-clav + azithromycin'],
        ['PE', 'Pleuritic chest pain, SOB, tachycardia, DVT risk', 'D-dimer (if low probability), CTPA', 'Anticoagulate: DOAC (rivaroxaban) first line; thrombolyse if massive PE with haemodynamic compromise'],
        ['Pneumothorax (tension)', 'Tracheal deviation, absent breath sounds, hypotension', 'Clinical diagnosis - do NOT wait for CXR', 'Immediate needle decompression (2nd ICS MCL), then chest drain'],
    ],
    col_widths=[2.8*cm, 4.2*cm, 4*cm, 6*cm]
))
story.append(sp(4))
story.append(alert_box('Asthma prevalence is 11% in Australia - high-yield for AMC. Know the stepwise management and criteria for hospital admission (PEFR <50%, SpO2 <92%, inability to speak in sentences).'))
story.append(sp(8))

# ── Gastroenterology ────────────────────────────────────────────
story.append(KeepTogether([
    Paragraph('GASTROENTEROLOGY', section_head),
    hline(),
]))
story.append(info_table(
    ['Condition', 'Key Features', 'Investigation', 'Treatment'],
    [
        ['GORD', 'Heartburn, regurgitation, worse lying flat', 'Clinical; endoscopy if alarm features', 'PPI first line; lifestyle modification; surgery (fundoplication) for refractory'],
        ['Peptic Ulcer Disease', 'Epigastric pain; DU relieved by food; GU worse with food', 'Gastroscopy; H. pylori testing (UBT, faecal antigen)', 'PPI + triple therapy (amoxicillin + clarithromycin + PPI) for H. pylori'],
        ['IBD - Crohn\'s', 'Skip lesions, transmural, any GI; perianal disease', 'Colonoscopy + biopsy; CRP, FBC', 'Steroids (acute); azathioprine, biologics (infliximab) for maintenance'],
        ['IBD - Ulcerative Colitis', 'Continuous from rectum; blood + mucus PR', 'Colonoscopy; CRP; AXR for toxic megacolon', '5-ASA (mild-mod); steroids (acute flare); colectomy if medical failure'],
        ['Acute Pancreatitis', 'Epigastric pain radiating to back; N&V; raised lipase/amylase', 'Lipase (preferred), CT abdomen, USS', 'IV fluids, analgesia, NBM; ERCP if gallstone-induced'],
        ['Colorectal Cancer', 'Change in bowel habit, PR bleeding, weight loss, anaemia', 'Colonoscopy + biopsy; CEA; CT staging', 'Surgical resection; adjuvant chemotherapy if nodal involvement'],
    ],
    col_widths=[3*cm, 4.5*cm, 4*cm, 5.5*cm]
))
story.append(sp(8))

# ── Neurology ───────────────────────────────────────────────────
story.append(KeepTogether([
    Paragraph('NEUROLOGY', section_head),
    hline(),
]))
story.append(info_table(
    ['Condition', 'Key Differentiator', 'Investigation', 'Management'],
    [
        ['Ischaemic Stroke', 'Sudden focal deficit; FAST positive; within hours', 'Non-contrast CT head first (exclude bleed); MRI-DWI gold standard', 'tPA within 4.5hr if no contraindications; endovascular thrombectomy within 24hr in selected'],
        ['TIA', 'Deficit fully resolves <24hr (usually <1hr)', 'MRI brain + vessel imaging; ECG (AF); carotid USS', 'ABCD2 score; dual antiplatelet 21 days then single; urgent specialist review'],
        ['Haemorrhagic stroke', 'Sudden severe headache (SAH) or focal deficit; blood on CT', 'Non-contrast CT; LP if CT negative for SAH (xanthochromia)', 'Reverse anticoagulation; BP control; neurosurgical consult; nimodipine for SAH'],
        ['Meningitis', 'Fever + headache + neck stiffness + photophobia; Kernig/Brudzinski', 'LP (after CT to exclude raised ICP); blood cultures', 'Dexamethasone + ceftriaxone IV immediately; do NOT delay for CT if no focal signs'],
        ['Epilepsy (status)', 'Seizure >5 min or repeated without recovery', 'EEG; glucose; electrolytes; toxicology', '1st: IV/IM lorazepam/diazepam; 2nd: IV levetiracetam/phenytoin; 3rd: general anaesthesia'],
        ['Parkinson\'s Disease', 'TRAP: Tremor (rest), Rigidity, Akinesia, Postural instability', 'Clinical diagnosis; DaT scan if uncertain', 'Levodopa (most effective); dopamine agonists; MAO-B inhibitors'],
    ],
    col_widths=[3*cm, 4.5*cm, 4*cm, 5.5*cm]
))
story.append(sp(4))
story.append(tip_box('Cardioembolic stroke is most commonly from AF. AMC will test: start anticoagulation for AF stroke, timing 2-14 days depending on infarct size.'))
story.append(sp(6))

# ── Renal ───────────────────────────────────────────────────────
story.append(KeepTogether([
    Paragraph('RENAL / NEPHROLOGY', section_head),
    hline(),
]))
story.append(info_table(
    ['Condition', 'Na', 'Urine Na', 'Urine Osm', 'Treatment'],
    [
        ['Pre-renal AKI', 'Normal/high', '<20 mmol/L', '>500 mOsm/kg', 'IV fluid resuscitation'],
        ['Intrinsic renal AKI', 'Normal', '>40 mmol/L', '<350 mOsm/kg', 'Stop nephrotoxins; treat cause (e.g. steroids for GN)'],
        ['Post-renal AKI', 'Normal', '>40 mmol/L', 'Variable', 'Relieve obstruction (catheter, nephrostomy)'],
        ['CKD Stage 3-5', 'Normal to low', 'Variable', 'Variable', 'ACEi/ARB; BP control <130/80; SGLT2i; low-protein diet; dialysis if stage 5'],
        ['Hyperkalaemia >6.5', 'Variable', '-', '-', 'ECG changes: calcium gluconate IV → salbutamol/insulin-dextrose → resonium/dialysis'],
    ],
    col_widths=[3.5*cm, 1.5*cm, 2*cm, 2*cm, 8*cm]
))
story.append(sp(8))

story.append(PageBreak())

# ════════════════════════════════════════════════════════════════
# CHAPTER 2: SURGERY
# ════════════════════════════════════════════════════════════════
story.append(chapter_banner('Chapter 2: Surgery',
    'Surgery constitutes 20% of the AMC MCQ blueprint', TEAL))
story.append(sp(10))

story.append(Paragraph('ACUTE ABDOMEN', section_head))
story.append(hline())
story.append(info_table(
    ['Condition', 'Classic Features', 'Investigation', 'Management'],
    [
        ['Appendicitis', 'Periumbilical pain migrating to RIF; Rovsing, McBurney, Psoas signs; fever, raised WCC', 'CT abdomen (gold standard); USS (paeds/pregnancy); Alvarado score', 'Appendicectomy (laparoscopic); IV ceftriaxone + metronidazole'],
        ['Cholecystitis', 'RUQ pain after fatty meal; Murphy\'s sign; fever; raised WCC', 'USS (gallstones, thick GB wall); LFTs; ALP', 'IV fluids, antibiotics; laparoscopic cholecystectomy (early preferred)'],
        ['Bowel Obstruction (SBO)', 'Colicky pain, distension, vomiting, obstipation; ladder pattern on AXR', 'AXR (dilated loops >3cm, air-fluid levels); CT abdomen', 'NBM, NGT, IV fluids; surgery if no resolution in 48hr or strangulation signs'],
        ['Perforated Peptic Ulcer', 'Sudden severe epigastric pain; peritonism; free air under diaphragm', 'Erect CXR (free air); CT if uncertain', 'Resuscitate; IV antibiotics; emergency laparotomy or laparoscopic repair'],
        ['Mesenteric Ischaemia', 'Severe pain out of proportion to exam; AF or atherosclerosis history', 'CT angiography; raised lactate', 'Emergency surgery; embolectomy or bowel resection; anticoagulation'],
        ['Acute Pancreatitis', 'Epigastric pain to back, N+V, raised lipase; gallstones or alcohol', 'Lipase, LFTs, USS; CT (Balthazar) for severity', 'IV fluids (aggressive), analgesia, NBM; ERCP if CBD stone; HDU/ICU if severe'],
    ],
    col_widths=[3*cm, 5*cm, 3.5*cm, 5.5*cm]
))
story.append(sp(6))

story.append(Paragraph('HERNIA', section_head))
story.append(hline())
story.append(info_table(
    ['Type', 'Location', 'Key Feature', 'Management'],
    [
        ['Inguinal (indirect)', 'Lateral to inf. epigastric, through deep ring, into scrotum', 'Most common; young males; controlled by deep ring pressure', 'Laparoscopic or open repair (Lichtenstein)'],
        ['Inguinal (direct)', 'Medial to inf. epigastric, through Hesselbach triangle', 'Older males; weakness of posterior wall', 'Mesh repair'],
        ['Femoral', 'Below inguinal ligament, medial to femoral vein', 'More common in females; HIGH risk of strangulation', 'Urgent surgical repair'],
        ['Incisional', 'Through prior surgical scar', 'Obesity, infection risk factors', 'Mesh repair; optimise weight first'],
        ['Strangulated hernia', 'Any type, non-reducible + ischaemia signs', 'Pain, tenderness, peritonism, bowel obstruction', 'Emergency surgery'],
    ],
    col_widths=[3.5*cm, 4.5*cm, 4.5*cm, 4.5*cm]
))
story.append(sp(6))

story.append(Paragraph('ORTHOPAEDICS', section_head))
story.append(hline())
story.append(info_table(
    ['Condition', 'Mechanism/Age', 'Diagnosis', 'Management'],
    [
        ['NOF Fracture', 'Elderly female, osteoporosis, fall on hip; shortened/externally rotated leg', 'X-ray hip; MRI if X-ray negative', 'Total hip replacement (displaced); dynamic hip screw (undisplaced/subcapital)'],
        ['Colles Fracture', 'Elderly, FOOSH; dorsal angulation (dinner fork deformity)', 'X-ray wrist', 'Cast if undisplaced; ORIF if displaced/unstable'],
        ['Compartment Syndrome', 'Post-fracture, cast; pain on passive stretch; pulseless, paraesthesia, paralysis', 'Clinical - do NOT wait for imaging', 'Emergency fasciotomy - the 6 Ps: Pain, Pallor, Paraesthesia, Paralysis, Pulselessness, Perishingly cold'],
        ['Septic Arthritis', 'Hot, swollen joint; fever; child or immunocompromised', 'Joint aspiration (WCC >50,000); blood cultures', 'IV antibiotics + urgent surgical washout (emergency)'],
    ],
    col_widths=[3*cm, 4.5*cm, 3.5*cm, 6*cm]
))
story.append(sp(4))
story.append(alert_box('Compartment syndrome: 6 Ps. Do NOT delay fasciotomy waiting for pulses to disappear. Paraesthesia is the earliest symptom. Remove all casts immediately.'))
story.append(sp(6))

story.append(Paragraph('UROLOGY', section_head))
story.append(hline())
story.append(info_table(
    ['Condition', 'Key Feature', 'Investigation', 'Management'],
    [
        ['Testicular Torsion', 'Sudden scrotal pain; high-riding testis; absent cremasteric reflex; teenager', 'Clinical! Doppler USS (but do NOT delay surgery for it)', 'Emergency surgical exploration within 6 hours - manual detorsion while waiting'],
        ['Renal Colic', 'Loin to groin pain; haematuria; writhing in pain', 'CT KUB (non-contrast); urine dipstick', 'Analgesia (NSAIDs first line); alpha-blocker for stones <10mm; urological referral if >10mm'],
        ['BPH', 'Elderly male; hesitancy, poor flow, nocturia, incomplete emptying', 'PSA, USS, flow studies', 'Alpha-blockers (tamsulosin); 5-alpha reductase inhibitors; TURP if medical failure'],
        ['Bladder Cancer', 'Painless haematuria; smoker/aniline dye exposure', 'Cystoscopy + biopsy; CT urogram', 'TURBT for superficial; radical cystectomy for muscle-invasive; intravesical BCG for high-risk'],
    ],
    col_widths=[3*cm, 4.5*cm, 3.5*cm, 6*cm]
))
story.append(sp(4))
story.append(alert_box('Testicular torsion is a surgical emergency. Salvage rate is >90% within 6 hours, drops to <10% after 24 hours. Any acute scrotal pain in a young male = torsion until proven otherwise.'))
story.append(sp(8))

story.append(PageBreak())

# ════════════════════════════════════════════════════════════════
# CHAPTER 3: PAEDIATRICS
# ════════════════════════════════════════════════════════════════
story.append(chapter_banner('Chapter 3: Paediatrics',
    'Paediatrics = 12.5% of blueprint | Focus: neonatal, GI, respiratory, development, immunisation', GOLD))
story.append(sp(10))

story.append(Paragraph('NEONATAL EMERGENCIES', section_head))
story.append(hline())
story.append(info_table(
    ['Condition', 'Key Feature', 'Investigation', 'Management'],
    [
        ['Pyloric Stenosis', '4-week-old; forceful PROJECTILE non-bilious vomiting post-feed; hungry after; "olive" mass', 'Ultrasound (pyloric muscle >4mm, length >19mm); hypochloraemic hypokalaemic metabolic alkalosis', 'Correct electrolytes FIRST; then Ramstedt pyloromyotomy'],
        ['Malrotation + Volvulus', 'Neonate; BILIOUS (green) vomiting = SURGICAL EMERGENCY', 'UGI series: duodenojejunal junction not in left upper quadrant; "corkscrew" sign', 'Emergency Ladd\'s procedure; every minute counts'],
        ['Hirschsprung Disease', 'Failure to pass meconium in 48hr; abdominal distension; "squirt sign" on rectal exam', 'Barium enema (transition zone); confirmed by RECTAL BIOPSY', 'Surgical resection of aganglionic segment'],
        ['Necrotising Enterocolitis', 'Premature neonate; abdominal distension; bloody stools; pneumatosis intestinalis on AXR', 'AXR (bowel wall gas = pathognomonic); blood cultures', 'NBM, NGT, IV antibiotics (gentamicin + metronidazole + ampicillin); surgery if perforation'],
        ['Oesophageal Atresia', 'Neonate with excessive secretions; fails to tolerate feeds; CXR shows coiled NGT in oesophagus', 'CXR with NGT; check for VACTERL associations', 'Surgical repair; suction of secretions; O2 as needed'],
    ],
    col_widths=[3*cm, 4.5*cm, 4.5*cm, 5*cm]
))
story.append(sp(6))

story.append(Paragraph('PAEDIATRIC GI VOMITING - QUICK REFERENCE (RCH Guidelines)', section_head))
story.append(hline())
story.append(info_table(
    ['Vomiting Type', 'Suspect', 'Age', 'Key Management'],
    [
        ['Projectile, non-bilious, post-feed', 'Pyloric Stenosis', '2-8 weeks', 'USS → correct electrolytes → pyloromyotomy'],
        ['Bilious (dark green)', 'GIT obstruction / Volvulus', 'Any age', 'SURGICAL EMERGENCY - urgent imaging + surgery'],
        ['With diarrhoea + fever', 'Gastroenteritis', 'Any age', 'ORT; Ondansetron if needed; assess dehydration'],
        ['Colicky pain + currant jelly stool', 'Intussusception', '5-12 months', 'USS → air enema reduction; surgery if failed/perforated'],
        ['No meconium + distension', 'Hirschsprung Disease', 'Newborn', 'Rectal biopsy → surgical resection'],
        ['From birth, non-projectile, thriving', 'GER / GORD', '0-12 months', 'Reassurance; positioning; thickened feeds; PPI if GORD'],
        ['Early morning, with headache', 'Raised ICP', 'Any age', 'CT head urgently; neurosurgical review'],
        ['Cyclic, well between episodes', 'Cyclic Vomiting Syndrome', '5-15 years', 'Ondansetron; prophylaxis with amitriptyline/propranolol'],
    ],
    col_widths=[4*cm, 3.5*cm, 2.5*cm, 7*cm]
))
story.append(sp(4))
story.append(tip_box('RCH Ondansetron dosing for gastroenteritis: 8-15kg = 2mg; 15-30kg = 4mg; >30kg = 8mg. Do NOT use routinely - reserve for significant vomiting with dehydration risk.'))
story.append(sp(6))

story.append(Paragraph('PAEDIATRIC RESPIRATORY', section_head))
story.append(hline())
story.append(info_table(
    ['Condition', 'Age', 'Key Features', 'Management'],
    [
        ['Croup (Laryngotracheobronchitis)', '6 months-3 years', 'Barking cough, inspiratory stridor, seal-like, worse at night; parainfluenza virus', 'Mild: oral dexamethasone 0.15-0.6mg/kg; Moderate-Severe: add nebulised adrenaline; O2 if SpO2 <92%'],
        ['Bronchiolitis', '<2 years', 'RSV; wheeze + crackles; low-grade fever; tachypnoea; first episode', 'Supportive: O2 to keep SpO2 ≥92%; NG/IV feeds if respiratory distress; NO steroids/bronchodilators'],
        ['Asthma (Paeds)', '>2 years', 'Wheeze + cough + SOB; reversible; atopy history; positive FHx', 'Mild: salbutamol MDI; Moderate: repeat salbutamol + ipratropium + oral pred; Severe: IV magnesium + ICU'],
        ['Epiglottitis', '2-7 years', 'Tripod position, drooling, muffled voice, stridor, HIGH fever; Hib', 'DO NOT examine throat! Urgent anaesthesia + ENT; IV ceftriaxone; secure airway first'],
        ['Pertussis', 'Any (often infants)', 'Paroxysmal cough + inspiratory whoop + post-tussive vomiting + cyanosis', 'Azithromycin; isolate; notify public health; vaccination (DTPa schedule)'],
    ],
    col_widths=[3.5*cm, 2.5*cm, 5*cm, 6*cm]
))
story.append(sp(4))
story.append(alert_box('Epiglottitis: Do NOT attempt to examine the throat or lay the child down. Secure airway in theatre with ENT+anaesthesia present. Thumb sign on lateral neck X-ray.'))
story.append(sp(6))

story.append(Paragraph('AUSTRALIAN IMMUNISATION SCHEDULE (AMC High-Yield)', section_head))
story.append(hline())
story.append(info_table(
    ['Age', 'Vaccines Given'],
    [
        ['Birth', 'Hepatitis B (hepB)'],
        ['6 weeks', 'DTPa-IPV-HepB-Hib (Infanrix-hexa), Rotavirus (oral), Pneumococcal 13v (PCV13), Meningococcal B'],
        ['4 months', 'DTPa-IPV-HepB-Hib, Rotavirus (oral), PCV13, Meningococcal B'],
        ['6 months', 'DTPa-IPV-HepB-Hib, Rotavirus (oral if 3-dose), PCV13, Influenza (annual from 6mo)'],
        ['12 months', 'MMR (measles-mumps-rubella), Pneumococcal 23v, Meningococcal ACWY, Hib booster'],
        ['18 months', 'MMR + Varicella (MMRV), DTPa booster, Hib'],
        ['4 years', 'DTPa-IPV (Infanrix-IPV), MMR (or MMRV)'],
        ['Year 7', 'HPV (2 doses, 6-12 months apart), dTpa (adolescent booster), Meningococcal ACWY booster'],
    ],
    col_widths=[2.5*cm, 14.5*cm]
))
story.append(sp(4))
story.append(tip_box('Key AMC immunisation facts: 12 months = MenACWY + PCV23; 18 months = MMRV + DTPa. HPV given in Year 7. Influenza vaccine is annual from 6 months. Catch-up schedules exist for late presentations.'))
story.append(sp(8))

story.append(Paragraph('CHILD DEVELOPMENT MILESTONES', section_head))
story.append(hline())
story.append(info_table(
    ['Age', 'Gross Motor', 'Fine Motor', 'Language', 'Social'],
    [
        ['2 months', 'Head control briefly', 'Follows to midline', 'Coos, social smile', 'Recognises faces'],
        ['4 months', 'Head steady, pushes on arms', 'Reaches for objects', 'Laughs', 'Enjoys interaction'],
        ['6 months', 'Sits with support', 'Transfers objects', 'Babbles', 'Stranger anxiety emerging'],
        ['9 months', 'Pulls to stand', 'Pincer grip emerging', 'Mama/dada (non-specific)', 'Waves bye-bye'],
        ['12 months', 'Stands alone, first steps', 'Neat pincer grip', '1 word with meaning', 'Points, symbolic play'],
        ['18 months', 'Walks well', 'Tower of 2-3 blocks', '10-20 words', 'Parallel play'],
        ['2 years', 'Runs, kicks ball', 'Tower of 6 blocks', '50+ words, 2-word phrases', 'Tantrums, parallel play'],
        ['3 years', 'Climbs stairs alternating', 'Copies circle', '3-word sentences, name', 'Cooperative play'],
        ['4 years', 'Hops on one foot', 'Copies cross', 'Full sentences, tells stories', 'Imaginative play'],
    ],
    col_widths=[2*cm, 3.5*cm, 3.5*cm, 4*cm, 4*cm]
))
story.append(sp(4))
story.append(alert_box('Developmental RED FLAGS: No social smile by 3 months; no sitting by 9 months; no walking by 18 months; no words by 18 months; loss of previously acquired skills (regression) at ANY age.'))
story.append(sp(8))

story.append(PageBreak())

# ════════════════════════════════════════════════════════════════
# CHAPTER 4: OBSTETRICS & GYNAECOLOGY
# ════════════════════════════════════════════════════════════════
story.append(chapter_banner('Chapter 4: Obstetrics & Gynaecology',
    'O&G = 12.5% of AMC MCQ blueprint | Key: Australian antenatal guidelines', TEAL))
story.append(sp(10))

story.append(Paragraph('ANTENATAL CARE (Australian Guidelines)', section_head))
story.append(hline())
story.append(info_table(
    ['Timing', 'Screening / Action'],
    [
        ['First visit (<10 weeks)', 'Blood group + Rh, FBC, rubella immunity, hepatitis B+C, HIV, syphilis, urine MCS, STI screen, booking USS'],
        ['11-13+6 weeks', 'Combined first trimester screening: PAPP-A + beta-hCG + NT USS (Down syndrome, trisomy 18/13)'],
        ['18-20 weeks', 'Morphology USS (structural anomalies)'],
        ['24-28 weeks', 'OGTT (75g, 2hr) for GDM; repeat FBC; anti-D if Rh-ve'],
        ['28 weeks', 'Anti-D immunoglobulin 625 IU if Rh-ve (if no prior sensitisation)'],
        ['36 weeks', 'Group B Streptococcus (GBS) swab (vaginal + rectal); discuss birth plan'],
        ['GBS positive', 'IV penicillin in labour (benzyl penicillin); clindamycin if penicillin allergic'],
    ],
    col_widths=[3.5*cm, 13.5*cm]
))
story.append(sp(4))
story.append(tip_box('GDM diagnosis criteria (IADPSG/WHO): Fasting ≥5.1 mmol/L OR 1hr ≥10.0 OR 2hr ≥8.5 mmol/L. Treatment: dietary first; if not controlled → metformin or insulin.'))
story.append(sp(6))

story.append(Paragraph('HYPERTENSIVE DISORDERS OF PREGNANCY', section_head))
story.append(hline())
story.append(info_table(
    ['Condition', 'Definition', 'Features', 'Management'],
    [
        ['Gestational Hypertension', 'BP ≥140/90 after 20 weeks; NO proteinuria or features', 'Asymptomatic; monitor closely', 'Labetalol or nifedipine; deliver at 37-38 weeks if controlled'],
        ['Pre-eclampsia', 'BP ≥140/90 after 20 weeks + proteinuria ≥300mg/24hr OR organ damage', 'Headache, visual changes, RUQ pain, oedema, proteinuria', 'Antihypertensives; MgSO4 for seizure prevention; deliver at ≥37 weeks (mild) or urgently if severe'],
        ['Eclampsia', 'Pre-eclampsia + seizures', 'Tonic-clonic seizure', 'MgSO4 4g IV loading dose; then 1g/hr maintenance; deliver after stabilisation'],
        ['HELLP Syndrome', 'Haemolysis + Elevated LFTs + Low Platelets', 'RUQ/epigastric pain, N+V, jaundice, bleeding', 'Delivery is definitive; steroids if <34 weeks; platelet transfusion if <20'],
        ['Chronic Hypertension', 'Pre-existing or BP ≥140/90 before 20 weeks', 'Often asymptomatic', 'Safe drugs in pregnancy: methyldopa, labetalol, nifedipine. AVOID ACEi/ARB.'],
    ],
    col_widths=[3*cm, 4*cm, 4*cm, 6*cm]
))
story.append(sp(4))
story.append(alert_box('MgSO4 toxicity: Loss of patellar reflex (first sign), respiratory arrest (serum Mg >7 mmol/L). Antidote: IV calcium gluconate 1g. Monitor urine output and reflexes.'))
story.append(sp(6))

story.append(Paragraph('LABOUR & DELIVERY', section_head))
story.append(hline())
story.append(info_table(
    ['Complication', 'Key Feature', 'Management'],
    [
        ['PPH (Primary)', 'Blood loss >500mL vaginal or >1000mL LSCS; within 24hr', '4 Ts: Tone (most common 80%) → Trauma → Tissue → Thrombin. Oxytocin 10u IM + IV oxytocin; bimanual compression; uterotonic escalation; surgical if needed'],
        ['Shoulder Dystocia', 'Head delivers, turtle sign, shoulders impacted', 'McRoberts + suprapubic pressure (first line); Rubin II / Woods screw; last resort: Zavanelli'],
        ['Cord Prolapse', 'Umbilical cord before presenting part after membrane rupture', 'Manual elevation of presenting part; urgent LSCS; knee-chest position; O2'],
        ['Placenta Praevia', 'Painless bright red PV bleeding after 20 weeks; placenta covering os', 'NO digital vaginal exam; USS; elective LSCS if grade 3-4'],
        ['Placental Abruption', 'Painful dark red bleeding; hard uterus; fetal distress; trauma history', 'Resuscitate; CTG; emergency LSCS if fetal compromise; DIC risk'],
        ['Uterine Rupture', 'Previous scar; sudden scar pain; fetal bradycardia; presenting part recedes', 'Emergency LSCS + repair or hysterectomy; maternal and fetal emergency'],
    ],
    col_widths=[3.5*cm, 5*cm, 8.5*cm]
))
story.append(sp(6))

story.append(Paragraph('GYNAECOLOGY', section_head))
story.append(hline())
story.append(info_table(
    ['Condition', 'Key Features', 'Investigation', 'Management'],
    [
        ['Ectopic Pregnancy', 'Amenorrhoea + PV bleeding + lower abdominal pain; positive bHCG; empty uterus on USS', 'Transvaginal USS; serial bHCG', 'Haemodynamically unstable: emergency laparoscopy. Stable + small: methotrexate (if no contraindications)'],
        ['Ovarian Torsion', 'Sudden severe unilateral pain; nausea; Doppler may show absent flow', 'Pelvic USS + Doppler; laparoscopy', 'Emergency laparoscopic detorsion (preserve ovary if possible)'],
        ['Endometriosis', 'Dysmenorrhoea, dyspareunia, infertility; cyclical pain', 'Laparoscopy (gold standard); CA-125 elevated', 'Hormonal (OCP, Mirena, GnRH agonists); surgical excision if severe'],
        ['Cervical Cancer Screening (Australia)', 'Cervical Screening Test (HPV-based)', 'Every 5 years (ages 25-74); HPV test + reflex LBC', 'Colposcopy if HPV 16/18 positive or abnormal LBC'],
        ['PCOS', 'Oligomenorrhoea, hirsutism, acne, obesity; LH:FSH >2:1; polycystic ovaries', 'USS; LH, FSH, testosterone, SHBG; OGTT (insulin resistance)', 'Weight loss; OCP for cycles/hirsutism; metformin; clomiphene for fertility'],
    ],
    col_widths=[3*cm, 5*cm, 3.5*cm, 5.5*cm]
))
story.append(sp(4))
story.append(tip_box('Australian cervical screening: HPV-based test every 5 years for women aged 25-74. This replaced the 2-yearly Pap smear in 2017. Know this difference - it is a frequent AMC question.'))
story.append(sp(8))

story.append(PageBreak())

# ════════════════════════════════════════════════════════════════
# CHAPTER 5: MENTAL HEALTH & PSYCHIATRY
# ════════════════════════════════════════════════════════════════
story.append(chapter_banner('Chapter 5: Mental Health & Psychiatry',
    'Psychiatry = 12.5% of blueprint | Focus: first-line drugs, risk assessment, legal frameworks', NAVY))
story.append(sp(10))

story.append(Paragraph('MOOD DISORDERS', section_head))
story.append(hline())
story.append(info_table(
    ['Disorder', 'Diagnosis', 'First-Line Treatment', 'AMC Key Points'],
    [
        ['Major Depressive Disorder', '≥2 weeks: depressed mood OR anhedonia + ≥5 symptoms total (SIG E CAPS)', 'SSRI (sertraline, escitalopram); CBT for mild-mod; combination for moderate-severe', 'Minimum 6-12 months treatment after remission. Screen for bipolar before prescribing antidepressants.'],
        ['Bipolar I', 'At least one manic episode (≥7 days: DIGFAST); may have depressive episodes', 'Mood stabiliser: lithium (gold standard) or valproate; antipsychotic for acute mania', 'Lithium monitoring: thyroid, renal function, serum levels. Toxic level >1.5 mmol/L.'],
        ['Bipolar II', 'At least one hypomanic episode + at least one major depressive episode', 'Lithium or lamotrigine; quetiapine for depression phase', 'AVOID antidepressant monotherapy (can trigger mania)'],
        ['Persistent Depressive Disorder (Dysthymia)', '≥2 years of depressed mood (not meeting MDD criteria)', 'SSRI + psychotherapy', 'Chronic, lower severity; high comorbidity with anxiety and substance use'],
        ['Postpartum Depression', 'Within 4 weeks to 12 months post-delivery; affects 10-15%', 'Psychotherapy first line if mild; SSRI if moderate-severe (sertraline is safest in breastfeeding)', 'Distinct from baby blues (<2 weeks, self-limiting). Screen at 6-week check.'],
    ],
    col_widths=[3*cm, 4*cm, 4.5*cm, 5.5*cm]
))
story.append(sp(4))
story.append(tip_box('SIG E CAPS mnemonic for depression: Sleep changes, Interest loss, Guilt/worthlessness, Energy low, Concentration poor, Appetite change, Psychomotor change, Suicidal ideation.'))
story.append(sp(6))

story.append(Paragraph('PSYCHOTIC DISORDERS', section_head))
story.append(hline())
story.append(info_table(
    ['Disorder', 'Duration', 'Features', 'Treatment'],
    [
        ['Schizophrenia', '≥6 months (≥1 month active)', 'Positive: hallucinations (auditory command), delusions, disorganised speech. Negative: flat affect, alogia, avolition, anhedonia', 'Atypical antipsychotic (risperidone, olanzapine, quetiapine); clozapine for treatment-resistant'],
        ['Brief Psychotic Disorder', '<1 month', 'Sudden onset psychosis, full recovery', 'Antipsychotic short course; identify precipitant'],
        ['Schizoaffective', '>1 month', 'Psychosis PLUS prominent mood episodes (concurrent)', 'Mood stabiliser + antipsychotic; lithium or valproate'],
        ['Delusional Disorder', '>1 month', 'Non-bizarre fixed delusions; otherwise functioning normally', 'Antipsychotic; often poorly compliant'],
    ],
    col_widths=[3.5*cm, 2.5*cm, 6*cm, 5*cm]
))
story.append(sp(4))
story.append(alert_box('Clozapine: requires mandatory weekly FBC for first 18 weeks (agranulocytosis risk). Only indicated in treatment-resistant schizophrenia (failed 2 adequate antipsychotic trials).'))
story.append(sp(6))

story.append(Paragraph('ANXIETY & RELATED DISORDERS', section_head))
story.append(hline())
story.append(info_table(
    ['Disorder', 'Key Features', 'First-Line Treatment'],
    [
        ['GAD', '≥6 months excessive worry; muscle tension, fatigue, irritability, poor concentration', 'SSRI or SNRI + CBT; buspirone as adjunct'],
        ['Panic Disorder', 'Recurrent unexpected panic attacks + anticipatory anxiety; agoraphobia possible', 'SSRI + CBT; benzodiazepines short-term only for acute attacks'],
        ['Social Anxiety Disorder', 'Fear of social situations; blushing, sweating, avoidance', 'SSRI + CBT; beta-blocker for performance anxiety (propranolol)'],
        ['OCD', 'Obsessions + compulsions, ego-dystonic, time-consuming (>1hr/day)', 'High-dose SSRI (e.g. fluoxetine 60-80mg) + ERP (CBT); clomipramine if resistant'],
        ['PTSD', 'Trauma + re-experiencing + avoidance + hyperarousal + negative cognitions; >1 month', 'Trauma-focused CBT (first line); SSRI (sertraline, paroxetine); avoid benzodiazepines'],
    ],
    col_widths=[3*cm, 7*cm, 7*cm]
))
story.append(sp(6))

story.append(Paragraph('SUBSTANCE USE DISORDERS', section_head))
story.append(hline())
story.append(info_table(
    ['Substance', 'Withdrawal Features', 'Management'],
    [
        ['Alcohol', 'Tremor, sweating, tachycardia (6-24hr); seizures (12-48hr); delirium tremens 48-72hr (fever, confusion, autonomic instability)', 'Diazepam or chlordiazepoxide (CIWA protocol); thiamine 100mg TDS or IV Pabrinex BEFORE glucose; seizure prophylaxis'],
        ['Opioids', 'Yawning, lacrimation, piloerection, diarrhoea, cramps, tachycardia, anxiety (not life-threatening)', 'Opioid replacement: methadone or buprenorphine/naloxone. Overdose: IV/IM naloxone'],
        ['Benzodiazepines', 'Similar to alcohol; potentially life-threatening; seizures, agitation', 'Long-acting diazepam taper; never abrupt cessation'],
        ['Amphetamines/stimulants', 'Crash: fatigue, depression, hypersomnia, craving', 'Supportive; no specific pharmacotherapy; CBT'],
        ['Nicotine', 'Irritability, cravings, weight gain, poor concentration', 'Combination NRT; varenicline (most effective); bupropion'],
    ],
    col_widths=[3*cm, 7*cm, 7*cm]
))
story.append(sp(4))
story.append(alert_box('Wernicke\'s Encephalopathy (alcohol): CLASSIC TRIAD - confusion + ophthalmoplegia + ataxia. Give IV thiamine (Pabrinex) BEFORE any glucose administration. If missed, progresses to Korsakoff psychosis (anterograde amnesia - irreversible).'))
story.append(sp(8))

story.append(PageBreak())

# ════════════════════════════════════════════════════════════════
# CHAPTER 6: POPULATION HEALTH & EMERGENCY MEDICINE
# ════════════════════════════════════════════════════════════════
story.append(chapter_banner('Chapter 6: Population Health & Emergency Medicine',
    'Population Health + Emergency = 12.5% of blueprint | Australian-specific guidelines critical', TEAL))
story.append(sp(10))

story.append(Paragraph('POPULATION HEALTH & SCREENING (Australian Guidelines)', section_head))
story.append(hline())
story.append(info_table(
    ['Screening Program', 'Target Population', 'Frequency / Method', 'Key AMC Points'],
    [
        ['Cervical Screening', 'Women 25-74 years', 'HPV-based Cervical Screening Test every 5 years', 'Replaced 2-yearly Pap smear in 2017. HPV 16/18 = urgent colposcopy.'],
        ['Bowel Cancer Screening (NBCSP)', 'Ages 45-74 (free kit); priority 50-74', 'Biennial faecal immunochemical test (FIT/iFOBT)', 'Positive FIT → colonoscopy. Australian government funded.'],
        ['Breast Screening (BreastScreen)', 'Women 40-74 (free 50-74)', 'Biennial mammogram', '2-view mammography; diagnostic mammogram if symptomatic at any age.'],
        ['Cardiovascular Risk', 'Adults ≥45 years (≥30 if Aboriginal/Torres Strait Islander)', 'Absolute CVD risk calculator (smoking, BP, cholesterol, diabetes, age, sex)', '≥15% 5-year risk = pharmacotherapy threshold. Lifestyle modification for 10-15%.'],
        ['Diabetes Screening', 'Age ≥40 + risk factors; ≥18 if Aboriginal/Torres Strait Islander', 'Fasting glucose or HbA1c or OGTT every 1-3 years', 'AUSDRISK tool for risk assessment.'],
        ['Antenatal Screening', 'All pregnant women', '11-13wk combined screening; 18-20wk morphology USS; 24-28wk OGTT', 'OGTT at 24-28 weeks is Australian standard. GBS swab at 36 weeks.'],
    ],
    col_widths=[3.5*cm, 3.5*cm, 4*cm, 6*cm]
))
story.append(sp(6))

story.append(Paragraph('EMERGENCY MEDICINE - HIGH YIELD ALGORITHMS', section_head))
story.append(hline())

story.append(Paragraph('Anaphylaxis (ASCIA Australian Guidelines)', sub_head))
story.append(info_table(
    ['Step', 'Action'],
    [
        ['1. Call for help', 'Activate emergency response; lie patient flat (or seated if SOB); raise legs unless SOB'],
        ['2. Adrenaline (FIRST LINE)', 'IM adrenaline 0.01 mg/kg (max 0.5mg) into outer mid-thigh. Adult: 0.5mg (0.5mL of 1:1000)'],
        ['3. Repeat if needed', 'Repeat adrenaline every 5 minutes if no improvement'],
        ['4. Call ambulance', '000; observe minimum 4-6 hours post-reaction; 12-24hr if biphasic risk'],
        ['5. Adjuncts', 'IV fluids for hypotension; salbutamol for bronchospasm; antihistamines and steroids are ADJUNCTS only - NOT first line'],
        ['6. Discharge', 'EpiPen prescription x2; ASCIA action plan; refer to allergist; MedicAlert bracelet'],
    ],
    col_widths=[3*cm, 14*cm]
))
story.append(sp(4))
story.append(alert_box('Adrenaline is the ONLY first-line treatment for anaphylaxis. Antihistamines and steroids are adjuncts. Pressure immobilisation bandage is for snake/funnel-web spider envenomation - NOT anaphylaxis.'))
story.append(sp(6))

story.append(Paragraph('Advanced Life Support (ALS) - Australian Resuscitation Council', sub_head))
story.append(info_table(
    ['Component', 'Details'],
    [
        ['Compression rate', '100-120/min; 30:2 ratio until advanced airway placed, then continuous compressions'],
        ['Compression depth', '≥5cm (adult); 1/3 chest depth (paeds)'],
        ['Defibrillation', 'Biphasic 200J (360J monophasic); shock every 2 min for shockable rhythms (VF/pVT)'],
        ['Shockable rhythms', 'VF and pulseless VT → shock + CPR'],
        ['Non-shockable rhythms', 'Asystole and PEA → CPR; identify reversible causes (4Hs + 4Ts)'],
        ['Adrenaline', 'Non-shockable: 1mg IV every 3-5 min from cycle 1. Shockable: after 3rd shock, then every 3-5 min'],
        ['Amiodarone', '300mg IV bolus after 3rd shock (VF/pVT); second dose 150mg after 5th shock'],
        ['4Hs', 'Hypoxia, Hypovolaemia, Hypo/hyperkalaemia, Hypothermia'],
        ['4Ts', 'Tension pneumothorax, Tamponade, Toxins, Thrombosis (PE or coronary)'],
    ],
    col_widths=[4*cm, 13*cm]
))
story.append(sp(6))

story.append(Paragraph('SNAKE ENVENOMATION (Australian)', sub_head))
story.append(info_table(
    ['Action', 'Details'],
    [
        ['First aid', 'Pressure Immobilisation Bandage (PIB) immediately; firm bandage from bite site + limb immobilised; do NOT wash wound'],
        ['Do NOT', 'Cut, suck, tourniquet, remove bandage until in hospital with antivenom and resuscitation available'],
        ['Hospital', 'FBC, coag (fibrinogen, D-dimer), renal function, CK; 12hr observation minimum'],
        ['Antivenom', 'Specific antivenom based on polyvalent snake venom detection kit or clinical syndrome; give IV in ED with adrenaline drawn up'],
        ['Funnel-web spider', 'PIB; antivenom available - highly effective; atropine for bradycardia'],
    ],
    col_widths=[3.5*cm, 13.5*cm]
))
story.append(sp(6))

story.append(Paragraph('ETHICS, CONSENT & LEGAL FRAMEWORK', section_head))
story.append(hline())
story.append(info_table(
    ['Topic', 'Key Principles for AMC'],
    [
        ['Informed Consent', 'Patient must have capacity; be given material information; consent voluntarily. Must disclose risks a reasonable patient would want to know (Rogers v Whitaker, Australia).'],
        ['Capacity Assessment', '4 components: Understand information, Retain it, Weigh it, Communicate decision. Can have capacity for some decisions but not others.'],
        ['Refusal of Treatment', 'Adult with capacity can refuse ANY treatment, even life-saving. Respect autonomy.'],
        ['Children & Consent', 'Parental consent for under 16; Gillick competence if child demonstrates sufficient maturity. Emergency: treat in best interests.'],
        ['Mandatory Reporting', 'Child abuse: mandatory in all Australian states. Notifiable diseases to public health. Impaired drivers: varies by state.'],
        ['Confidentiality', 'Can be breached to prevent serious harm to identifiable third party (Tarasoff principle); to comply with law; to notify public health authorities.'],
        ['Advanced Care Directive', 'Legally binding if made when competent; must be followed. Enduring Power of Attorney (medical) for when capacity lost.'],
        ['Euthanasia/VAD', 'Voluntary Assisted Dying is legal in all Australian states (varies by criteria). Doctor may conscientiously object but must refer.'],
    ],
    col_widths=[4*cm, 13*cm]
))
story.append(sp(6))

story.append(Paragraph('INDIGENOUS HEALTH (AMC - Culturally Safe Practice)', section_head))
story.append(hline())
story.append(info_table(
    ['Topic', 'Key Points'],
    [
        ['Health disparities', 'Aboriginal and Torres Strait Islander peoples have 5.1 years lower life expectancy. Higher rates of CVD, diabetes, renal disease, mental health, infectious disease.'],
        ['Screening age differences', 'CVD risk screening from age 30; diabetes screening from age 18; bowel screening supported at younger ages.'],
        ['Cultural safety', 'Involve Aboriginal Health Workers; use interpreters; understand importance of family and community; avoid assumptions.'],
        ['Closing the Gap', 'Australian government strategy targeting Indigenous health equity. Includes health checks (MBS item 715 - annual Indigenous health assessment).'],
        ['MBS Item 715', 'Annual health assessment for Aboriginal and Torres Strait Islander people; includes BP, diabetes, smoking, alcohol, mental health, dental, eyes, ears.'],
        ['Communication', 'Allow silence; avoid interrupting; use plain language; acknowledge country; involve family in decisions when appropriate.'],
    ],
    col_widths=[4*cm, 13*cm]
))
story.append(sp(6))

# ── Final exam strategy ─────────────────────────────────────────
story.append(PageBreak())
story.append(chapter_banner('AMC MCQ Exam Strategy', 'Maximise your score on exam day', GOLD))
story.append(sp(10))
story.append(info_table(
    ['Strategy', 'Detail'],
    [
        ['Read the question last', 'Read the stem first, identify the clinical problem, THEN read the question. Prevents anchoring bias.'],
        ['Identify the "best answer"', 'AMC uses A-type questions: one BEST answer from 5 plausible options. Eliminate obvious wrong answers first.'],
        ['Australian guidelines priority', 'When in doubt between management options, choose what Australian guidelines (RCH, RANZCOG, Cardiac Society of Australia) recommend.'],
        ['Common > rare', 'AMC tests prevalence-based thinking. Always consider the most common diagnosis first unless red flag features point away.'],
        ['Emergency before investigation', 'For unstable patients: ALWAYS stabilise before investigating. Airway > Breathing > Circulation.'],
        ['Do not change answers', 'First instinct is usually correct unless you have a clear reason to change. Avoid second-guessing without new information.'],
        ['Timing', '3.5 hours for 150 questions = 84 seconds per question. Aim to finish 10-15 min early for review.'],
        ['Paediatrics is high-yield', 'Often underprepared by IMGs. Focus on immunisation schedule, developmental milestones, and GI emergencies.'],
        ['Indigenous health always relevant', 'At least a few questions will involve Aboriginal/Torres Strait Islander patients. Always consider culturally safe and equitable care.'],
    ],
    col_widths=[4.5*cm, 12.5*cm]
))
story.append(sp(8))

story.append(tip_box('TOP 5 AMC HIGHEST-YIELD TOPICS: (1) CVD risk management and ACS, (2) Diabetes and GDM, (3) Paediatric immunisation schedule, (4) Pre-eclampsia and eclampsia management, (5) Mental health first-line medications and risk assessment.', bg=LIGHT_GOLD, border=GOLD, label='FINAL TIP'))
story.append(sp(6))
story.append(hline(NAVY, 2))
story.append(sp(4))
story.append(Paragraph(
    'AMC MCQ Quick Reference Guide | Prepared for International Medical Graduates | '
    'Based on AMC MCQ Exam Specifications V8 (2025) | RCH, RANZCOG, Cardiac Society, '
    'RACGP, and Australian Government Health Guidelines | Last updated July 2026',
    make_style('disclaimer', fontSize=8, textColor=HexColor('#7F8C8D'),
               alignment=TA_CENTER, fontName='Helvetica')
))

# ── Build ────────────────────────────────────────────────────────
doc.build(story, onFirstPage=on_page, onLaterPages=on_page)
print(f'PDF successfully created: {OUTPUT}')