const pptxgen = require("pptxgenjs");
const { execSync } = require("child_process");

// ── FETCH IMAGES ──────────────────────────────────────────────────────────────
const imgUrls = [
  "https://cdn.orris.care/cdss_images/3cbc4636bf5eab3b8a5ba1bd65db2ed1e1e1ff08138b9a178cb1d5f9ec6cd70d.png", // CT E.coli bronchopneumonia
  "https://cdn.orris.care/cdss_images/10da1b7fd41ebfc0d092754cbd55c84ca41f93229dd401fb2eae77d575bfdc5d.png", // CXR H.influenzae
  "https://cdn.orris.care/cdss_images/49da3cf81ecd2aceeaf66aa4136991bef125b21d49fcb46b5db151f3dc42225c.png", // CT Pseudomonas abscess
];
const imgs = JSON.parse(
  execSync(`node /home/daytona/skills/shared/scripts/fetch_images.js ${imgUrls.map(u => `"${u}"`).join(" ")}`).toString()
);

// ── PALETTE ───────────────────────────────────────────────────────────────────
const C = {
  navy:    "0B1F3A",   // dominant dark bg
  teal:    "1B8A8F",   // accent
  amber:   "E8A020",   // warning / emergency accent
  red:     "C0392B",   // emergency red
  white:   "FFFFFF",
  offWhite:"F0F4F8",
  silver:  "BDC9D7",
  darkCard:"112940",   // slightly lighter than navy for cards
  midCard: "163352",   // card surface
};

// ── HELPERS ───────────────────────────────────────────────────────────────────
function navyBg(slide) {
  slide.addShape("rect", { x: 0, y: 0, w: 10, h: 5.625, fill: { color: C.navy }, line: { color: C.navy } });
}
function tealBar(slide, x, y, w, h) {
  slide.addShape("rect", { x, y, w, h, fill: { color: C.teal }, line: { color: C.teal } });
}
function amberBar(slide, x, y, w, h) {
  slide.addShape("rect", { x, y, w, h, fill: { color: C.amber }, line: { color: C.amber } });
}
function redBar(slide, x, y, w, h) {
  slide.addShape("rect", { x, y, w, h, fill: { color: C.red }, line: { color: C.red } });
}
function card(slide, x, y, w, h, color) {
  slide.addShape("rect", {
    x, y, w, h,
    fill: { color: color || C.midCard },
    line: { color: color || C.midCard },
    shadow: { type: "outer", color: "000000", blur: 8, offset: 3, angle: 135, opacity: 0.25 }
  });
}
function sectionLabel(slide, text, color) {
  slide.addText(text, {
    x: 0, y: 0, w: 10, h: 0.38,
    fill: { color: color || C.teal },
    fontSize: 11, bold: true, color: C.white,
    align: "center", valign: "middle", margin: 0,
    charSpacing: 3
  });
}
function slideTitle(slide, text, color) {
  slide.addText(text, {
    x: 0.45, y: 0.45, w: 9.1, h: 0.7,
    fontSize: 26, bold: true, color: color || C.white,
    fontFace: "Calibri", margin: 0
  });
}
function accentLine(slide, color) {
  tealBar(slide, 0.45, 1.18, 1.0, 0.05);
  // override color if needed
}

// ══════════════════════════════════════════════════════════════════════════════
// BUILD PRESENTATION
// ══════════════════════════════════════════════════════════════════════════════
const pres = new pptxgen();
pres.layout = "LAYOUT_16x9";
pres.title  = "Chest X-Ray Interpretation: Bronchopneumonia & Emergencies";
pres.author = "Orris Medical";

// ══════════════════════════════════════════════════════════════════════════════
// SLIDE 1 — TITLE
// ══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  navyBg(sl);
  // large teal left strip
  sl.addShape("rect", { x: 0, y: 0, w: 0.18, h: 5.625, fill: { color: C.teal }, line: { color: C.teal } });
  // amber accent strip
  sl.addShape("rect", { x: 0.18, y: 0, w: 0.07, h: 5.625, fill: { color: C.amber }, line: { color: C.amber } });

  sl.addText("CHEST X-RAY\nINTERPRETATION", {
    x: 0.55, y: 0.9, w: 9.1, h: 2.0,
    fontSize: 46, bold: true, color: C.white,
    fontFace: "Calibri", charSpacing: 2,
    align: "left", valign: "top"
  });
  sl.addText("Bronchopneumonia Diagnosis · Differential Diagnosis · Radiological Emergencies", {
    x: 0.55, y: 2.95, w: 9.1, h: 0.55,
    fontSize: 16, color: C.silver, fontFace: "Calibri", align: "left"
  });
  // bottom bar
  sl.addShape("rect", { x: 0, y: 5.1, w: 10, h: 0.525, fill: { color: C.teal }, line: { color: C.teal } });
  sl.addText("Based on Grainger & Allison's Diagnostic Radiology · Fishman's Pulmonary Diseases", {
    x: 0.3, y: 5.1, w: 9.4, h: 0.525,
    fontSize: 11, color: C.white, italic: true, align: "center", valign: "middle", margin: 0
  });
}

// ══════════════════════════════════════════════════════════════════════════════
// SLIDE 2 — AGENDA / OUTLINE
// ══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  navyBg(sl);
  sectionLabel(sl, "OVERVIEW", C.teal);
  slideTitle(sl, "What We Will Cover");
  sl.addShape("rect", { x: 0.45, y: 1.22, w: 1.0, h: 0.05, fill: { color: C.teal }, line: { color: C.teal } });

  const topics = [
    ["01", "Systematic CXR Reading — ABCDE Approach"],
    ["02", "Bronchopneumonia: Pathophysiology & X-Ray Pattern"],
    ["03", "Bronchopneumonia: Clinical Signs & Symptoms"],
    ["04", "Organism-Specific Radiological Clues"],
    ["05", "Differential Diagnosis of Consolidation"],
    ["06", "X-Ray Emergencies & Their Clinical Alarms"],
    ["07", "Summary Comparison Table"],
  ];

  topics.forEach(([num, title], i) => {
    const row = Math.floor(i / 2);
    const col = i % 2;
    const x = col === 0 ? 0.45 : 5.3;
    const y = 1.45 + row * 0.95;
    card(sl, x, y, 4.6, 0.78, C.midCard);
    sl.addText(num, { x: x + 0.12, y: y + 0.08, w: 0.55, h: 0.62, fontSize: 22, bold: true, color: C.teal, valign: "middle", margin: 0 });
    sl.addText(title, { x: x + 0.7, y: y + 0.08, w: 3.75, h: 0.62, fontSize: 13, color: C.white, valign: "middle", fontFace: "Calibri", margin: 0 });
    // If last item (odd count), center it
    if (i === topics.length - 1 && topics.length % 2 !== 0) {
      // already placed at col=0; just leave it
    }
  });
}

// ══════════════════════════════════════════════════════════════════════════════
// SLIDE 3 — ABCDE SYSTEMATIC APPROACH
// ══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  navyBg(sl);
  sectionLabel(sl, "SYSTEMATIC APPROACH", C.teal);
  slideTitle(sl, "ABCDE Method for Reading Chest X-Rays");
  sl.addShape("rect", { x: 0.45, y: 1.22, w: 1.0, h: 0.05, fill: { color: C.teal }, line: { color: C.teal } });

  const rows = [
    { letter: "A", label: "AIRWAY", desc: "Trachea — midline or deviated? Carina angle (<70°)?", color: C.teal },
    { letter: "B", label: "BONES & SOFT TISSUE", desc: "Ribs, clavicles, scapulae — fractures? Subcutaneous emphysema?", color: "1A7A6E" },
    { letter: "C", label: "CARDIAC & MEDIASTINUM", desc: "Heart size (CTR <50%), mediastinal width (<8 cm on PA), aortic knuckle clarity", color: C.amber },
    { letter: "D", label: "DIAPHRAGM", desc: "Level (R higher than L), contour, free subdiaphragmatic air?", color: "7B5EA7" },
    { letter: "E", label: "EVERYTHING ELSE", desc: "Lung fields, hila, pleural spaces, costophrenic angles, lines & tubes", color: C.teal },
  ];

  rows.forEach((r, i) => {
    const y = 1.4 + i * 0.79;
    card(sl, 0.4, y, 9.2, 0.72, C.midCard);
    sl.addShape("rect", { x: 0.4, y, w: 0.6, h: 0.72, fill: { color: r.color }, line: { color: r.color } });
    sl.addText(r.letter, { x: 0.4, y: y + 0.04, w: 0.6, h: 0.64, fontSize: 26, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
    sl.addText(r.label, { x: 1.1, y: y + 0.06, w: 2.5, h: 0.28, fontSize: 12, bold: true, color: C.amber, margin: 0 });
    sl.addText(r.desc, { x: 1.1, y: y + 0.35, w: 8.3, h: 0.3, fontSize: 11.5, color: C.silver, margin: 0, fontFace: "Calibri" });
  });
}

// ══════════════════════════════════════════════════════════════════════════════
// SLIDE 4 — BRONCHOPNEUMONIA PATHOPHYSIOLOGY
// ══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  navyBg(sl);
  sectionLabel(sl, "BRONCHOPNEUMONIA", C.teal);
  slideTitle(sl, "Pathophysiology: Why It Looks Patchy");
  sl.addShape("rect", { x: 0.45, y: 1.22, w: 1.0, h: 0.05, fill: { color: C.teal }, line: { color: C.teal } });

  // Left: flow diagram
  const steps = [
    { label: "Acute Bronchitis", sub: "Infection starts in bronchi/bronchioles" },
    { label: "Peribronchial Spread", sub: "Inflammatory exudate fills surrounding alveoli" },
    { label: "Multifocal Consolidation", sub: "Multiple patchy opacities in same/multiple lobes" },
    { label: "Confluent Disease", sub: "Segments coalesce → diffuse consolidation (severe)" },
  ];
  steps.forEach((s, i) => {
    const y = 1.38 + i * 0.96;
    card(sl, 0.4, y, 5.2, 0.78, C.midCard);
    sl.addShape("rect", { x: 0.4, y, w: 0.45, h: 0.78, fill: { color: C.teal }, line: { color: C.teal } });
    sl.addText(`${i + 1}`, { x: 0.4, y: y + 0.1, w: 0.45, h: 0.58, fontSize: 20, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
    sl.addText(s.label, { x: 0.95, y: y + 0.06, w: 4.5, h: 0.28, fontSize: 13, bold: true, color: C.amber, margin: 0 });
    sl.addText(s.sub, { x: 0.95, y: y + 0.36, w: 4.5, h: 0.3, fontSize: 11.5, color: C.silver, margin: 0 });
    // Arrow between steps
    if (i < steps.length - 1) {
      sl.addText("▼", { x: 2.5, y: y + 0.78, w: 0.6, h: 0.18, fontSize: 11, color: C.teal, align: "center", margin: 0 });
    }
  });

  // Right: vs lobar pneumonia
  card(sl, 5.9, 1.38, 3.75, 3.82, C.darkCard);
  sl.addText("vs. LOBAR PNEUMONIA", { x: 6.0, y: 1.48, w: 3.5, h: 0.35, fontSize: 12, bold: true, color: C.amber, align: "center", margin: 0 });
  sl.addShape("rect", { x: 6.2, y: 1.85, w: 3.1, h: 0.04, fill: { color: C.teal }, line: { color: C.teal } });

  const compare = [
    ["Feature", "Bronchopneumonia", "Lobar Pneumonia"],
    ["Origin", "Airways (bronchi)", "Alveoli directly"],
    ["Pattern", "Patchy / multifocal", "Homogeneous lobar"],
    ["Fissures", "Does NOT cross", "Bounded by fissures"],
    ["Air-bronchogram", "Variable", "Classic feature"],
    ["Organism", "Staph, Pseudomonas, H.flu", "Pneumococcus"],
  ];
  compare.forEach(([f, b, l], i) => {
    const y = 1.95 + i * 0.5;
    const hdr = i === 0;
    sl.addText(f, { x: 5.95, y, w: 1.15, h: 0.42, fontSize: hdr ? 10 : 10.5, bold: hdr, color: hdr ? C.amber : C.silver, valign: "middle", margin: 0 });
    sl.addText(b, { x: 7.12, y, w: 1.25, h: 0.42, fontSize: hdr ? 10 : 10, bold: hdr, color: hdr ? C.amber : C.white, valign: "middle", margin: 0 });
    sl.addText(l, { x: 8.38, y, w: 1.22, h: 0.42, fontSize: hdr ? 10 : 10, bold: hdr, color: hdr ? C.amber : C.white, valign: "middle", margin: 0 });
    if (!hdr) sl.addShape("rect", { x: 5.95, y: y + 0.42, w: 3.65, h: 0.02, fill: { color: "1D3F5E" }, line: { color: "1D3F5E" } });
  });
}

// ══════════════════════════════════════════════════════════════════════════════
// SLIDE 5 — CXR FEATURES WITH IMAGE
// ══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  navyBg(sl);
  sectionLabel(sl, "BRONCHOPNEUMONIA — RADIOLOGY", C.teal);
  slideTitle(sl, "Classic X-Ray & CT Features");
  sl.addShape("rect", { x: 0.45, y: 1.22, w: 1.0, h: 0.05, fill: { color: C.teal }, line: { color: C.teal } });

  // Left: feature list
  const features = [
    { icon: "●", text: "Multifocal patchy, ill-defined opacities — the hallmark" },
    { icon: "●", text: "Bilateral involvement (~40% of S. aureus cases)" },
    { icon: "●", text: "Lower lobe predominance (though any lobe can be affected)" },
    { icon: "●", text: "Segmental distribution — does NOT cross fissures" },
    { icon: "●", text: "Air bronchogram may be present" },
    { icon: "●", text: "Possible cavitation (Staph, Pseudomonas, Klebsiella)" },
    { icon: "●", text: "Pleural effusion 30–50% (Staph aureus)" },
    { icon: "CT", text: "Tree-in-bud pattern, centrilobular nodules (CT finding)" },
  ];

  features.forEach((f, i) => {
    const y = 1.38 + i * 0.47;
    const isCT = f.icon === "CT";
    sl.addShape("rect", { x: 0.4, y: y + 0.05, w: 0.38, h: 0.32,
      fill: { color: isCT ? C.amber : C.teal }, line: { color: isCT ? C.amber : C.teal } });
    sl.addText(isCT ? "CT" : "●", { x: 0.4, y: y + 0.05, w: 0.38, h: 0.32, fontSize: isCT ? 9 : 14, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
    sl.addText(f.text, { x: 0.85, y: y + 0.06, w: 4.4, h: 0.33, fontSize: 12, color: C.white, valign: "middle", fontFace: "Calibri", margin: 0 });
  });

  // Right: actual CT image
  card(sl, 5.55, 1.33, 4.1, 3.82, C.darkCard);
  if (imgs[0] && !imgs[0].error) {
    sl.addImage({ data: imgs[0].base64, x: 5.65, y: 1.43, w: 3.9, h: 3.3 });
  }
  sl.addText("CT: E. coli Bronchopneumonia — bilateral peripheral consolidations (arrows)", {
    x: 5.55, y: 4.78, w: 4.1, h: 0.38,
    fontSize: 9, color: C.silver, italic: true, align: "center", valign: "middle", margin: 0
  });
}

// ══════════════════════════════════════════════════════════════════════════════
// SLIDE 6 — CLINICAL SIGNS & SYMPTOMS
// ══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  navyBg(sl);
  sectionLabel(sl, "BRONCHOPNEUMONIA — CLINICAL", C.teal);
  slideTitle(sl, "Clinical Signs & Symptoms");
  sl.addShape("rect", { x: 0.45, y: 1.22, w: 1.0, h: 0.05, fill: { color: C.teal }, line: { color: C.teal } });

  const categories = [
    {
      title: "CONSTITUTIONAL", color: C.teal,
      items: ["High fever & rigors", "Malaise, fatigue", "Tachycardia", "Dehydration signs"]
    },
    {
      title: "RESPIRATORY", color: C.amber,
      items: ["Productive cough (purulent/mucopurulent sputum)", "Dyspnoea & tachypnoea", "Pleuritic chest pain (variable)", "Reduced chest expansion"]
    },
    {
      title: "AUSCULTATION", color: "1A7A6E",
      items: ["Crepitations (coarse crackles)", "Bronchial breathing over consolidation", "Reduced breath sounds", "Pleural rub (if effusion)"]
    },
    {
      title: "PERCUSSION & OTHER", color: "7B5EA7",
      items: ["Dullness to percussion over consolidation", "Tachypnoea (RR >20)", "SpO2 drop", "CURB-65 score for severity (ICU if ≥3)"]
    },
  ];

  categories.forEach((cat, i) => {
    const col = i % 2;
    const row = Math.floor(i / 2);
    const x = col === 0 ? 0.4 : 5.15;
    const y = 1.38 + row * 2.1;
    card(sl, x, y, 4.5, 1.95, C.midCard);
    sl.addShape("rect", { x, y, w: 4.5, h: 0.38, fill: { color: cat.color }, line: { color: cat.color } });
    sl.addText(cat.title, { x: x + 0.12, y: y + 0.04, w: 4.26, h: 0.3, fontSize: 11, bold: true, color: C.white, charSpacing: 2, margin: 0 });
    sl.addText(cat.items.map(it => `• ${it}`).join("\n"), {
      x: x + 0.12, y: y + 0.45, w: 4.26, h: 1.4,
      fontSize: 11, color: C.white, fontFace: "Calibri", valign: "top", margin: 0
    });
  });
}

// ══════════════════════════════════════════════════════════════════════════════
// SLIDE 7 — ORGANISM-SPECIFIC CXR CLUES WITH CXR IMAGE
// ══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  navyBg(sl);
  sectionLabel(sl, "ORGANISM-SPECIFIC PATTERNS", C.teal);
  slideTitle(sl, "Radiological Clues by Pathogen");
  sl.addShape("rect", { x: 0.45, y: 1.22, w: 1.0, h: 0.05, fill: { color: C.teal }, line: { color: C.teal } });

  const orgs = [
    { name: "S. aureus", clue: "Bilateral; cavitation, pneumatoceles, pleural effusion (30–50%)", color: C.red },
    { name: "E. coli", clue: "Multilobar lower lobe consolidations; bilateral peripheral pattern", color: C.amber },
    { name: "Pseudomonas", clue: "Confluent + cavitating; upper lobe predominance; tree-in-bud", color: "C06A15" },
    { name: "H. influenzae", clue: "Bilateral ill-defined lower lobe consolidations", color: C.teal },
    { name: "Klebsiella", clue: "Dense lobar consolidation; fissure bulging; rapid cavitation", color: "7B5EA7" },
    { name: "Mycoplasma", clue: "Focal reticulonodular in one lobe; segmental/lobular GGO", color: "1A7A6E" },
    { name: "Viral (Influenza)", clue: "Bilateral GGO; rapid progression resembling pulmonary oedema", color: "2A6699" },
  ];

  orgs.forEach((o, i) => {
    const y = 1.38 + i * 0.56;
    card(sl, 0.4, y, 5.65, 0.48, C.midCard);
    sl.addShape("rect", { x: 0.4, y, w: 1.6, h: 0.48, fill: { color: o.color }, line: { color: o.color } });
    sl.addText(o.name, { x: 0.4, y: y + 0.04, w: 1.6, h: 0.4, fontSize: 12, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
    sl.addText(o.clue, { x: 2.1, y: y + 0.06, w: 3.85, h: 0.36, fontSize: 11.5, color: C.white, valign: "middle", fontFace: "Calibri", margin: 0 });
  });

  // Right: CXR image
  card(sl, 6.3, 1.33, 3.35, 3.82, C.darkCard);
  if (imgs[1] && !imgs[1].error) {
    sl.addImage({ data: imgs[1].base64, x: 6.4, y: 1.43, w: 3.15, h: 3.3 });
  }
  sl.addText("CXR: H. influenzae bronchopneumonia — bilateral ill-defined consolidations (arrows)", {
    x: 6.3, y: 4.78, w: 3.35, h: 0.38,
    fontSize: 9, color: C.silver, italic: true, align: "center", valign: "middle", margin: 0
  });
}

// ══════════════════════════════════════════════════════════════════════════════
// SLIDE 8 — DIFFERENTIAL DIAGNOSIS OF CONSOLIDATION
// ══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  navyBg(sl);
  sectionLabel(sl, "DIFFERENTIAL DIAGNOSIS", C.teal);
  slideTitle(sl, "Differential Diagnosis of Consolidation on CXR");
  sl.addShape("rect", { x: 0.45, y: 1.22, w: 1.0, h: 0.05, fill: { color: C.teal }, line: { color: C.teal } });

  // Rule at top
  card(sl, 0.4, 1.3, 9.2, 0.52, "0E3352");
  sl.addText("⚠  KEY RULE: First ask — Is this ACUTE or CHRONIC? Chronic (>6 weeks) shifts DDx toward malignancy, organizing pneumonia, or TB/fungal.", {
    x: 0.55, y: 1.35, w: 8.9, h: 0.4, fontSize: 11.5, color: C.amber, bold: true, valign: "middle", margin: 0
  });

  const diffs = [
    { cond: "Lobar Pneumonia", xray: "Homogeneous lobar consolidation; air-bronchogram; respects fissures", clue: "Fever, productive cough; pneumococcal", color: C.teal },
    { cond: "Pulmonary Oedema", xray: "Bat-wing perihilar shadowing; Kerley B lines; upper lobe diversion; cardiomegaly", clue: "Orthopnoea, PND, raised JVP; cardiac history", color: C.amber },
    { cond: "ARDS", xray: "Diffuse bilateral consolidation; no cardiomegaly; no Kerley lines", clue: "Post-sepsis/trauma; PaO2/FiO2 <300", color: C.red },
    { cond: "Aspiration Pneumonitis", xray: "Dependent lobe consolidation (posterior upper / lower lobes); right-sided", clue: "Aspiration event, reduced consciousness, swallowing disorder", color: "C06A15" },
    { cond: "TB", xray: "Upper lobe consolidation + cavitation; satellite nodules; lymphadenopathy", clue: "Subacute course, weight loss, night sweats; contact history", color: "7B5EA7" },
    { cond: "Bronchoalveolar Ca / COP", xray: "Persistent consolidation failing to resolve with antibiotics; may migrate (COP)", clue: "Chronic non-productive cough; steroid-responsive (COP)", color: "1A7A6E" },
    { cond: "Pulmonary Infarction (PE)", xray: "Hampton's hump (wedge peripheral opacity); raised hemidiaphragm; effusion", clue: "Pleuritic pain, haemoptysis, DVT risk factors", color: "2A6699" },
  ];

  diffs.forEach((d, i) => {
    const y = 1.9 + i * 0.5;
    card(sl, 0.4, y, 9.2, 0.44, C.midCard);
    sl.addShape("rect", { x: 0.4, y, w: 1.8, h: 0.44, fill: { color: d.color }, line: { color: d.color } });
    sl.addText(d.cond, { x: 0.45, y: y + 0.04, w: 1.7, h: 0.36, fontSize: 10.5, bold: true, color: C.white, valign: "middle", align: "center", margin: 0 });
    sl.addText(d.xray, { x: 2.28, y: y + 0.04, w: 4.15, h: 0.36, fontSize: 10, color: C.white, valign: "middle", margin: 0 });
    sl.addShape("rect", { x: 6.45, y: y + 0.04, w: 0.03, h: 0.36, fill: { color: C.silver }, line: { color: C.silver } });
    sl.addText(d.clue, { x: 6.52, y: y + 0.04, w: 3.0, h: 0.36, fontSize: 10, color: C.silver, valign: "middle", italic: true, margin: 0 });
  });
}

// ══════════════════════════════════════════════════════════════════════════════
// SLIDE 9 — EMERGENCY 1: Tension Pneumothorax
// ══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  navyBg(sl);
  sectionLabel(sl, "RADIOLOGICAL EMERGENCIES", C.red);
  // Red alert banner
  sl.addShape("rect", { x: 0, y: 0.38, w: 10, h: 0.75, fill: { color: C.red }, line: { color: C.red } });
  sl.addText("⚡  TENSION PNEUMOTHORAX", {
    x: 0.3, y: 0.38, w: 9.4, h: 0.75,
    fontSize: 26, bold: true, color: C.white, valign: "middle", fontFace: "Calibri", charSpacing: 1, margin: 0
  });

  // Warning note
  card(sl, 0.4, 1.25, 9.2, 0.5, "3B0A0A");
  sl.addText("⚠  DO NOT WAIT FOR CXR — Diagnose clinically. Immediate needle decompression at 2nd ICS, mid-clavicular line.", {
    x: 0.55, y: 1.3, w: 8.9, h: 0.4, fontSize: 11.5, color: C.amber, bold: true, valign: "middle", margin: 0
  });

  // Two columns
  card(sl, 0.4, 1.85, 4.4, 3.4, C.midCard);
  sl.addShape("rect", { x: 0.4, y: 1.85, w: 4.4, h: 0.38, fill: { color: C.red }, line: { color: C.red } });
  sl.addText("CXR SIGNS", { x: 0.52, y: 1.88, w: 4.15, h: 0.32, fontSize: 12, bold: true, color: C.white, charSpacing: 2, margin: 0 });

  const xraySigns = [
    "Complete lung collapse (ipsilateral)",
    "Tracheal deviation AWAY from affected side",
    "Mediastinal shift away from affected side",
    "Depression/inversion of ipsilateral hemidiaphragm",
    "Widening of ipsilateral intercostal spaces",
    "Absent lung markings on affected side",
  ];
  sl.addText(xraySigns.map(s => `• ${s}`).join("\n"), {
    x: 0.55, y: 2.3, w: 4.1, h: 2.8, fontSize: 12, color: C.white, fontFace: "Calibri", valign: "top", margin: 0
  });

  card(sl, 5.2, 1.85, 4.4, 3.4, C.midCard);
  sl.addShape("rect", { x: 5.2, y: 1.85, w: 4.4, h: 0.38, fill: { color: "7B1818" }, line: { color: "7B1818" } });
  sl.addText("CLINICAL SIGNS", { x: 5.32, y: 1.88, w: 4.15, h: 0.32, fontSize: 12, bold: true, color: C.white, charSpacing: 2, margin: 0 });

  const clinSigns = [
    "Sudden severe dyspnoea & tachycardia",
    "Hypotension — obstructive shock",
    "Absent breath sounds on affected side",
    "Tracheal deviation (away from lesion)",
    "Distended neck veins (JVD)",
    "Cyanosis & cardiovascular collapse",
  ];
  sl.addText(clinSigns.map(s => `• ${s}`).join("\n"), {
    x: 5.35, y: 2.3, w: 4.1, h: 2.8, fontSize: 12, color: C.white, fontFace: "Calibri", valign: "top", margin: 0
  });
}

// ══════════════════════════════════════════════════════════════════════════════
// SLIDE 10 — EMERGENCY 2: Acute Pulmonary Oedema
// ══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  navyBg(sl);
  sectionLabel(sl, "RADIOLOGICAL EMERGENCIES", C.red);
  sl.addShape("rect", { x: 0, y: 0.38, w: 10, h: 0.75, fill: { color: "1B5E9A" }, line: { color: "1B5E9A" } });
  sl.addText("⚡  ACUTE PULMONARY OEDEMA (LVF)", {
    x: 0.3, y: 0.38, w: 9.4, h: 0.75,
    fontSize: 24, bold: true, color: C.white, valign: "middle", fontFace: "Calibri", charSpacing: 1, margin: 0
  });

  card(sl, 0.4, 1.25, 4.55, 4.0, C.midCard);
  sl.addShape("rect", { x: 0.4, y: 1.25, w: 4.55, h: 0.38, fill: { color: "1B5E9A" }, line: { color: "1B5E9A" } });
  sl.addText("CXR SIGNS", { x: 0.52, y: 1.28, w: 4.28, h: 0.32, fontSize: 12, bold: true, color: C.white, charSpacing: 2, margin: 0 });
  const oedXray = [
    "Cardiomegaly (CTR >50%)",
    "Bilateral perihilar 'bat-wing' / butterfly shadowing",
    "Upper lobe blood diversion (prominent upper lobe vessels)",
    "Kerley B lines (short horizontal peripheral lines)",
    "Bilateral pleural effusions (usually)",
    "Fluid in horizontal (minor) fissure",
    "Patchy bilateral airspace opacification",
  ];
  sl.addText(oedXray.map(s => `• ${s}`).join("\n"), {
    x: 0.55, y: 1.7, w: 4.25, h: 3.4, fontSize: 11.5, color: C.white, fontFace: "Calibri", valign: "top", margin: 0
  });

  card(sl, 5.2, 1.25, 4.45, 4.0, C.midCard);
  sl.addShape("rect", { x: 5.2, y: 1.25, w: 4.45, h: 0.38, fill: { color: "0D3F6E" }, line: { color: "0D3F6E" } });
  sl.addText("CLINICAL SIGNS", { x: 5.32, y: 1.28, w: 4.18, h: 0.32, fontSize: 12, bold: true, color: C.white, charSpacing: 2, margin: 0 });
  const oedClin = [
    "Acute onset dyspnoea & orthopnoea",
    "Paroxysmal nocturnal dyspnoea (PND)",
    "Pink frothy sputum",
    "Bilateral fine crepitations (basal → apical)",
    "Raised JVP",
    "S3 gallop rhythm",
    "History of cardiac disease / hypertension",
    "Cold peripheries, diaphoresis",
  ];
  sl.addText(oedClin.map(s => `• ${s}`).join("\n"), {
    x: 5.35, y: 1.7, w: 4.15, h: 3.4, fontSize: 11.5, color: C.white, fontFace: "Calibri", valign: "top", margin: 0
  });
}

// ══════════════════════════════════════════════════════════════════════════════
// SLIDE 11 — EMERGENCY 3: Aortic Dissection + Pneumomediastinum
// ══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  navyBg(sl);
  sectionLabel(sl, "RADIOLOGICAL EMERGENCIES", C.red);

  // Top half: Aortic dissection
  sl.addShape("rect", { x: 0, y: 0.38, w: 10, h: 0.65, fill: { color: "6B1010" }, line: { color: "6B1010" } });
  sl.addText("⚡  AORTIC DISSECTION", { x: 0.3, y: 0.38, w: 9.4, h: 0.65, fontSize: 22, bold: true, color: C.white, valign: "middle", margin: 0 });

  card(sl, 0.4, 1.1, 4.4, 2.05, C.midCard);
  sl.addShape("rect", { x: 0.4, y: 1.1, w: 4.4, h: 0.35, fill: { color: "6B1010" }, line: { color: "6B1010" } });
  sl.addText("CXR SIGNS", { x: 0.52, y: 1.13, w: 4.15, h: 0.28, fontSize: 11, bold: true, color: C.white, charSpacing: 2, margin: 0 });
  sl.addText([
    { text: "• Widened mediastinum ", options: { breakLine: true } },
    { text: "  (>8 cm on PA — KEY sign)\n", options: { bold: true, color: C.amber, breakLine: true } },
    { text: "• Loss of aortic knuckle clarity\n", options: { breakLine: true } },
    { text: "• Left pleural effusion\n", options: { breakLine: true } },
    { text: "• Trachea/NGT deviation to right\n", options: { breakLine: true } },
    { text: "• 'Double density' aortic wall", options: {} },
  ], { x: 0.55, y: 1.5, w: 4.1, h: 1.55, fontSize: 11, color: C.white, fontFace: "Calibri", valign: "top", margin: 0 });

  card(sl, 5.2, 1.1, 4.4, 2.05, C.midCard);
  sl.addShape("rect", { x: 5.2, y: 1.1, w: 4.4, h: 0.35, fill: { color: "4A0808" }, line: { color: "4A0808" } });
  sl.addText("CLINICAL SIGNS", { x: 5.32, y: 1.13, w: 4.15, h: 0.28, fontSize: 11, bold: true, color: C.white, charSpacing: 2, margin: 0 });
  sl.addText([
    { text: "• Sudden TEARING pain → back (hallmark)\n", options: { bold: true, color: C.amber, breakLine: true } },
    { text: "• Unequal BP both arms (>20 mmHg)\n", options: { breakLine: true } },
    { text: "• Pulse deficits\n", options: { breakLine: true } },
    { text: "• Syncope, neurological deficits\n", options: { breakLine: true } },
    { text: "• Escalate immediately — CT angiography", options: { bold: true, color: C.amber } },
  ], { x: 5.35, y: 1.5, w: 4.1, h: 1.55, fontSize: 11, color: C.white, fontFace: "Calibri", valign: "top", margin: 0 });

  // Divider
  sl.addShape("rect", { x: 0.4, y: 3.22, w: 9.2, h: 0.04, fill: { color: C.teal }, line: { color: C.teal } });

  // Bottom half: Pneumomediastinum
  sl.addText("⚡  PNEUMOMEDIASTINUM / BOERHAAVE SYNDROME", { x: 0.4, y: 3.3, w: 9.2, h: 0.45, fontSize: 18, bold: true, color: C.amber, valign: "middle", margin: 0 });

  card(sl, 0.4, 3.82, 4.4, 1.48, C.midCard);
  sl.addText("CXR: Air along mediastinal borders • Continuous diaphragm sign • Air around heart", {
    x: 0.55, y: 3.92, w: 4.1, h: 1.25, fontSize: 11, color: C.white, fontFace: "Calibri", valign: "top", margin: 0
  });
  card(sl, 5.2, 3.82, 4.4, 1.48, C.midCard);
  sl.addText("Clinical: Subcutaneous emphysema (neck crepitus) • Hamman's sign (mediastinal crunch) • Severe chest pain after forceful vomiting → SURGICAL EMERGENCY", {
    x: 5.35, y: 3.92, w: 4.1, h: 1.25, fontSize: 11, color: C.white, fontFace: "Calibri", valign: "top", margin: 0
  });
}

// ══════════════════════════════════════════════════════════════════════════════
// SLIDE 12 — EMERGENCY 4: Massive Effusion + Necrotizing Pneumonia
// ══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  navyBg(sl);
  sectionLabel(sl, "RADIOLOGICAL EMERGENCIES", C.red);

  // Top: Massive Pleural Effusion/Haemothorax
  sl.addShape("rect", { x: 0, y: 0.38, w: 10, h: 0.65, fill: { color: "3A2700" }, line: { color: "3A2700" } });
  sl.addText("⚡  MASSIVE PLEURAL EFFUSION / HAEMOTHORAX", { x: 0.3, y: 0.38, w: 9.4, h: 0.65, fontSize: 20, bold: true, color: C.amber, valign: "middle", margin: 0 });

  card(sl, 0.4, 1.1, 4.4, 1.9, C.midCard);
  sl.addShape("rect", { x: 0.4, y: 1.1, w: 4.4, h: 0.35, fill: { color: "3A2700" }, line: { color: "3A2700" } });
  sl.addText("CXR SIGNS", { x: 0.52, y: 1.13, w: 4.15, h: 0.28, fontSize: 11, bold: true, color: C.white, charSpacing: 2, margin: 0 });
  sl.addText("• Uniform white-out of one hemithorax\n• Trachea & mediastinum deviated AWAY from effusion (if massive)\n• Loss of diaphragm & costophrenic angle\n• Meniscus sign (smaller effusions)", {
    x: 0.55, y: 1.5, w: 4.1, h: 1.4, fontSize: 11, color: C.white, fontFace: "Calibri", valign: "top", margin: 0
  });
  card(sl, 5.2, 1.1, 4.4, 1.9, C.midCard);
  sl.addShape("rect", { x: 5.2, y: 1.1, w: 4.4, h: 0.35, fill: { color: "2A1A00" }, line: { color: "2A1A00" } });
  sl.addText("CLINICAL SIGNS", { x: 5.32, y: 1.13, w: 4.15, h: 0.28, fontSize: 11, bold: true, color: C.white, charSpacing: 2, margin: 0 });
  sl.addText("• Stony dullness to percussion\n• Absent breath sounds at base\n• Reduced chest expansion\n• Dyspnoea, tachycardia, hypoxia\n• Trauma history (haemothorax)", {
    x: 5.35, y: 1.5, w: 4.1, h: 1.4, fontSize: 11, color: C.white, fontFace: "Calibri", valign: "top", margin: 0
  });

  sl.addShape("rect", { x: 0.4, y: 3.08, w: 9.2, h: 0.04, fill: { color: C.teal }, line: { color: C.teal } });

  // Bottom: Necrotizing/Septic Pneumonia
  sl.addText("⚡  NECROTIZING PNEUMONIA / SEPTIC SHOCK", { x: 0.4, y: 3.17, w: 9.2, h: 0.45, fontSize: 18, bold: true, color: C.red, valign: "middle", margin: 0 });

  card(sl, 0.4, 3.68, 4.4, 1.65, C.midCard);
  sl.addShape("rect", { x: 0.4, y: 3.68, w: 4.4, h: 0.35, fill: { color: C.red }, line: { color: C.red } });
  sl.addText("CXR SIGNS", { x: 0.52, y: 3.71, w: 4.15, h: 0.28, fontSize: 11, bold: true, color: C.white, charSpacing: 2, margin: 0 });
  sl.addText("• Bilateral multilobar consolidation\n• Bilateral pleural effusions (high-mortality sign)\n• Cavitation within consolidation → abscess\n• Rapid progression on serial films", {
    x: 0.55, y: 4.08, w: 4.1, h: 1.2, fontSize: 11, color: C.white, fontFace: "Calibri", valign: "top", margin: 0
  });
  card(sl, 5.2, 3.68, 4.4, 1.65, C.midCard);
  sl.addShape("rect", { x: 5.2, y: 3.68, w: 4.4, h: 0.35, fill: { color: "7B1010" }, line: { color: "7B1010" } });
  sl.addText("CLINICAL SIGNS", { x: 5.32, y: 3.71, w: 4.15, h: 0.28, fontSize: 11, bold: true, color: C.white, charSpacing: 2, margin: 0 });
  sl.addText("• High fever, rigors, tachycardia\n• Hypotension (septic shock)\n• Confusion / altered mental status\n• CURB-65 ≥3 → ICU admission\n• SpO2 dropping despite O2", {
    x: 5.35, y: 4.08, w: 4.1, h: 1.2, fontSize: 11, color: C.white, fontFace: "Calibri", valign: "top", margin: 0
  });
}

// ══════════════════════════════════════════════════════════════════════════════
// SLIDE 13 — SUMMARY COMPARISON TABLE
// ══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  navyBg(sl);
  sectionLabel(sl, "SUMMARY", C.teal);
  slideTitle(sl, "Bronchopneumonia vs. Key Differentials — At a Glance");
  sl.addShape("rect", { x: 0.45, y: 1.22, w: 1.0, h: 0.05, fill: { color: C.teal }, line: { color: C.teal } });

  // Table header
  const headers = ["Feature", "Bronchopneumonia", "Lobar Pneumonia", "Pulm. Oedema", "TB", "ARDS"];
  const colW = [1.7, 1.64, 1.64, 1.64, 1.64, 1.64];
  const startX = [0.15, 1.85, 3.49, 5.13, 6.77, 8.41];
  const headerY = 1.38;

  headers.forEach((h, i) => {
    sl.addShape("rect", { x: startX[i], y: headerY, w: colW[i], h: 0.42, fill: { color: i === 0 ? C.teal : C.midCard }, line: { color: C.navy } });
    sl.addText(h, { x: startX[i] + 0.05, y: headerY + 0.04, w: colW[i] - 0.1, h: 0.34, fontSize: 10.5, bold: true, color: i === 0 ? C.white : C.amber, valign: "middle", align: "center", margin: 0 });
  });

  const rows = [
    ["Distribution", "Multifocal patchy bilateral", "Single lobe homogeneous", "Bilateral perihilar/basal", "Upper lobe", "Diffuse bilateral"],
    ["Borders", "Ill-defined", "Lobar margin", "Bat-wing perihilar", "Cavities/nodules", "Diffuse"],
    ["Air bronchogram", "Variable", "Classic (YES)", "Absent (usually)", "Absent", "Present"],
    ["Cavitation", "YES (Staph/Pseudomonas)", "Rare", "No", "Common", "Rare"],
    ["Pleural effusion", "Possible (Staph 30–50%)", "Parapneumonic possible", "Bilateral", "Possible", "Uncommon"],
    ["Cardiomegaly", "No", "No", "YES", "No", "No"],
    ["Kerley B lines", "No", "No", "YES", "No", "No"],
    ["Clinical key", "Fever + productive cough", "Fever + single-lobe sx", "Orthopnoea + JVD", "Wt loss + night sweats", "Post-insult + no cardiac"],
  ];

  const rowColors = ["0E2440", C.midCard, "0E2440", C.midCard, "0E2440", C.midCard, "0E2440", C.midCard];

  rows.forEach((row, ri) => {
    const y = 1.8 + ri * 0.455;
    row.forEach((cell, ci) => {
      sl.addShape("rect", { x: startX[ci], y, w: colW[ci], h: 0.44, fill: { color: rowColors[ri] }, line: { color: C.navy } });
      const highlight = (cell.toUpperCase().includes("YES") || cell.includes("Classic")) ? C.amber : C.white;
      sl.addText(cell, {
        x: startX[ci] + 0.04, y: y + 0.03, w: colW[ci] - 0.08, h: 0.38,
        fontSize: ci === 0 ? 10 : 9.5,
        bold: ci === 0,
        color: ci === 0 ? C.amber : highlight,
        valign: "middle", align: ci === 0 ? "left" : "center", margin: 0
      });
    });
  });
}

// ══════════════════════════════════════════════════════════════════════════════
// SLIDE 14 — CT IMAGE SLIDE: Pseudomonas Abscess
// ══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  navyBg(sl);
  sectionLabel(sl, "RADIOLOGY IN FOCUS", C.teal);
  slideTitle(sl, "Cavitation & Abscess Formation in Bronchopneumonia");
  sl.addShape("rect", { x: 0.45, y: 1.22, w: 1.0, h: 0.05, fill: { color: C.amber }, line: { color: C.amber } });

  // Image
  card(sl, 0.4, 1.35, 5.5, 3.9, C.darkCard);
  if (imgs[2] && !imgs[2].error) {
    sl.addImage({ data: imgs[2].base64, x: 0.5, y: 1.45, w: 5.3, h: 3.5 });
  }
  sl.addText("CT: Pseudomonas aeruginosa Pneumonia — extensive right upper lobe consolidation with necrosis and abscess formation (arrows). Vascular structures visible within consolidated lung (arrowheads).", {
    x: 0.4, y: 5.28, w: 5.5, h: 0.32, fontSize: 9, color: C.silver, italic: true, align: "center", margin: 0
  });

  // Key points
  card(sl, 6.15, 1.35, 3.5, 3.9, C.midCard);
  sl.addShape("rect", { x: 6.15, y: 1.35, w: 3.5, h: 0.38, fill: { color: C.amber }, line: { color: C.amber } });
  sl.addText("CAVITATION — CAUSES", { x: 6.27, y: 1.38, w: 3.25, h: 0.3, fontSize: 11, bold: true, color: C.navy, charSpacing: 2, margin: 0 });

  const cavItems = [
    { org: "S. aureus", note: "Pneumatoceles in children; abscesses in adults (15–30%)" },
    { org: "Pseudomonas", note: "Confluent; frequently cavitates; upper lobe" },
    { org: "Klebsiella", note: "Rapid cavitation; fissure bulging; lung gangrene" },
    { org: "Anaerobes", note: "Aspiration-related; foul-smelling sputum" },
    { org: "TB", note: "Upper lobe; thick-walled; satellite nodules" },
  ];
  cavItems.forEach((item, i) => {
    const y = 1.85 + i * 0.66;
    sl.addText(item.org, { x: 6.27, y, w: 1.1, h: 0.28, fontSize: 11, bold: true, color: C.amber, margin: 0 });
    sl.addText(item.note, { x: 6.27, y: y + 0.28, w: 3.25, h: 0.32, fontSize: 10.5, color: C.silver, fontFace: "Calibri", margin: 0 });
  });
}

// ══════════════════════════════════════════════════════════════════════════════
// SLIDE 15 — CONCLUSION / KEY TAKEAWAYS
// ══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  navyBg(sl);
  sl.addShape("rect", { x: 0, y: 0, w: 0.18, h: 5.625, fill: { color: C.teal }, line: { color: C.teal } });
  sl.addShape("rect", { x: 0.18, y: 0, w: 0.07, h: 5.625, fill: { color: C.amber }, line: { color: C.amber } });

  sl.addText("KEY TAKEAWAYS", {
    x: 0.55, y: 0.3, w: 9.1, h: 0.6,
    fontSize: 28, bold: true, color: C.teal, charSpacing: 3, margin: 0
  });

  const takeaways = [
    { n: "1", t: "Bronchopneumonia = patchy, multifocal, airway-first spread. Does NOT cross fissures.", c: C.teal },
    { n: "2", t: "Always correlate CXR with clinical context — consolidation has many causes (infection, oedema, ARDS, cancer, PE).", c: C.amber },
    { n: "3", t: "Cavitation on CXR → think S. aureus, Pseudomonas, Klebsiella, TB, anaerobes.", c: "1A7A6E" },
    { n: "4", t: "Emergency #1: Tension pneumothorax — diagnose and treat CLINICALLY. Do not wait for CXR.", c: C.red },
    { n: "5", t: "Emergency #2: Wide mediastinum (>8 cm) → Aortic dissection until proven otherwise. Escalate immediately.", c: "7B1818" },
    { n: "6", t: "Bat-wing shadowing + Kerley B + cardiomegaly → pulmonary oedema, NOT pneumonia.", c: "1B5E9A" },
    { n: "7", t: "Use ABCDE systematically — missing an emergency on CXR can be fatal.", c: "7B5EA7" },
  ];

  takeaways.forEach((t, i) => {
    const y = 1.0 + i * 0.63;
    sl.addShape("rect", { x: 0.55, y: y + 0.06, w: 0.35, h: 0.44, fill: { color: t.c }, line: { color: t.c } });
    sl.addText(t.n, { x: 0.55, y: y + 0.06, w: 0.35, h: 0.44, fontSize: 16, bold: true, color: C.white, align: "center", valign: "middle", margin: 0 });
    sl.addText(t.t, { x: 1.0, y: y + 0.08, w: 8.5, h: 0.44, fontSize: 12.5, color: C.white, valign: "middle", fontFace: "Calibri", margin: 0 });
  });

  sl.addShape("rect", { x: 0, y: 5.2, w: 10, h: 0.425, fill: { color: C.teal }, line: { color: C.teal } });
  sl.addText("Sources: Grainger & Allison's Diagnostic Radiology · Fishman's Pulmonary Diseases · Radiology Assistant · Radiology Masterclass", {
    x: 0.3, y: 5.2, w: 9.4, h: 0.425, fontSize: 9.5, color: C.white, italic: true, align: "center", valign: "middle", margin: 0
  });
}

// ── WRITE FILE ─────────────────────────────────────────────────────────────
const outPath = "/home/daytona/workspace/chest-xray-pptx/ChestXray_Bronchopneumonia_Emergencies.pptx";
pres.writeFile({ fileName: outPath }).then(() => {
  console.log("SUCCESS:", outPath);
}).catch(err => {
  console.error("ERROR:", err);
});

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/chest-xray-pptx/build.js'

const pptxgen = require("pptxgenjs");

const pres = new pptxgen();
pres.layout = "LAYOUT_WIDE"; // 13.3 x 7.5 — wide format for cheat sheet density
pres.title = "Medical Triads Cheat Sheet";

// ── PALETTE ───────────────────────────────────────────────────────────────────
const C = {
  bg:      "0D1B2A",   // deep navy bg
  panel:   "112236",   // slightly lighter panel
  card:    "162C46",   // card bg
  border:  "1A3A5C",   // subtle border
  white:   "FFFFFF",
  silver:  "B8C8D8",
  gold:    "F0A500",   // accent headings
  teal:    "17B8BE",   // neuro
  red:     "E8354A",   // emergency
  orange:  "E87525",   // cardio
  green:   "27AE60",   // GI
  purple:  "8E44AD",   // neuro2
  blue:    "2980B9",   // infective
  pink:    "E91E8C",   // OB/GYN
  lime:    "7CB518",   // ortho
  cyan:    "00BCD4",   // ENT
  maroon:  "C0392B",   // heme
};

// ── HELPERS ───────────────────────────────────────────────────────────────────
function bg(sl) {
  sl.addShape("rect", { x:0, y:0, w:13.3, h:7.5, fill:{color:C.bg}, line:{color:C.bg} });
}

function hdr(sl, text, color, x, y, w, h) {
  sl.addShape("rect", { x, y, w, h, fill:{color:color}, line:{color:color} });
  sl.addText(text, { x:x+0.06, y:y+0.02, w:w-0.12, h:h-0.04,
    fontSize:9, bold:true, color:C.white, valign:"middle", align:"center", margin:0, charSpacing:1 });
}

function cell(sl, text, x, y, w, h, opts={}) {
  const bgColor = opts.bg || C.card;
  const fColor  = opts.fc || C.white;
  const fSize   = opts.fs || 8.5;
  sl.addShape("rect", { x, y, w, h, fill:{color:bgColor}, line:{color:C.border} });
  sl.addText(text, { x:x+0.05, y:y+0.02, w:w-0.1, h:h-0.04,
    fontSize:fSize, color:fColor, valign:"middle", align:opts.align||"left",
    bold:!!opts.bold, italic:!!opts.italic, margin:0, fontFace:"Calibri",
    wrap: true });
}

function sectionTitle(sl, text, color, x, y, w) {
  sl.addShape("rect", { x, y, w, h:0.28, fill:{color:color}, line:{color:color} });
  sl.addShape("rect", { x, y:y+0.28, w, h:0.03, fill:{color:C.gold}, line:{color:C.gold} });
  sl.addText(text, { x:x+0.08, y:y, w:w-0.16, h:0.28,
    fontSize:9.5, bold:true, color:C.white, valign:"middle", charSpacing:2, margin:0 });
}

// ═══════════════════════════════════════════════════════════════════════════════
//  SLIDE 1 — TITLE / COVER
// ═══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  bg(sl);
  // Decorative stripes
  const stripes = [C.red,C.orange,C.green,C.teal,C.purple,C.blue,C.pink,C.lime,C.cyan,C.gold];
  stripes.forEach((c,i) => {
    sl.addShape("rect",{x:0,y:i*0.75,w:0.22,h:0.75,fill:{color:c},line:{color:c}});
  });
  sl.addShape("rect",{x:0.22,y:0,w:0.06,h:7.5,fill:{color:C.gold},line:{color:C.gold}});

  sl.addText("MEDICAL TRIADS", {
    x:0.55, y:1.2, w:12.5, h:1.6,
    fontSize:72, bold:true, color:C.white, fontFace:"Calibri",
    charSpacing:8, align:"left", margin:0
  });
  sl.addText("DIAGNOSTIC CHEAT SHEET", {
    x:0.55, y:2.9, w:12.5, h:0.65,
    fontSize:28, bold:false, color:C.gold, fontFace:"Calibri",
    charSpacing:5, align:"left", margin:0
  });
  sl.addText("Comparison Tables by Specialty · Maximum Symptoms per Triad · Emergency Flags", {
    x:0.55, y:3.65, w:12.5, h:0.45,
    fontSize:15, color:C.silver, align:"left", margin:0
  });

  // Specialty pills at bottom
  const specs = [
    {t:"EMERGENCY", c:C.red}, {t:"CARDIOLOGY", c:C.orange}, {t:"NEUROLOGY", c:C.teal},
    {t:"GI/HEPATOLOGY", c:C.green}, {t:"INFECTIOUS", c:C.blue}, {t:"RHEUMATOLOGY", c:C.purple},
    {t:"NEPHROLOGY", c:"1A8A9A"}, {t:"ENDOCRINE", c:C.gold}, {t:"OB/GYN", c:C.pink},
    {t:"ORTHOPAEDICS", c:C.lime}, {t:"ENT", c:C.cyan}, {t:"HAEMATOLOGY", c:C.maroon},
  ];
  specs.forEach((s,i) => {
    const x = 0.55 + (i % 6) * 2.1;
    const y = 4.35 + Math.floor(i/6) * 0.52;
    sl.addShape("rect",{x,y,w:1.95,h:0.38,fill:{color:s.c},line:{color:s.c},
      shadow:{type:"outer",color:"000000",blur:4,offset:2,angle:135,opacity:0.2}});
    sl.addText(s.t,{x:x+0.05,y:y+0.03,w:1.85,h:0.32,fontSize:9,bold:true,color:C.white,
      align:"center",valign:"middle",margin:0,charSpacing:1});
  });

  sl.addShape("rect",{x:0,y:7.1,w:13.3,h:0.4,fill:{color:C.gold},line:{color:C.gold}});
  sl.addText("Sources: Bailey & Love's Surgery · Rosen's Emergency Medicine · Washington Manual · Frameworks for Internal Medicine · Sleisenger & Fordtran's GI · Schwartz's Surgery",{
    x:0.2,y:7.1,w:12.9,h:0.4,fontSize:8,color:C.bg,align:"center",valign:"middle",margin:0});
}

// ═══════════════════════════════════════════════════════════════════════════════
//  SLIDE 2 — EMERGENCY & CARDIOVASCULAR TRIADS
// ═══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  bg(sl);

  // Title bar
  sl.addShape("rect",{x:0,y:0,w:13.3,h:0.38,fill:{color:C.red},line:{color:C.red}});
  sl.addText("⚡  EMERGENCY & CARDIOVASCULAR TRIADS — Comparison Table",{
    x:0.15,y:0,w:13,h:0.38,fontSize:13,bold:true,color:C.white,valign:"middle",charSpacing:1,margin:0});

  // ── TABLE HEADERS ──────────────────────────────────────────────────────────
  const cols = { name:0.12, dx:3.2, s1:5.1, s2:7.1, s3:9.1, extra:11.1 };
  const cw   = { name:3.06, dx:1.88, s1:1.98, s2:1.98, s3:1.98, extra:2.18 };
  const hy = 0.42;

  hdr(sl,"TRIAD NAME",         cols.name, hy, cw.name, 0.3, C.red);
  hdr(sl,"DIAGNOSIS",          cols.dx,   hy, cw.dx,   0.3, "8B1A1A");
  hdr(sl,"SYMPTOM 1",          cols.s1,   hy, cw.s1,   0.3, "1A3A6B");
  hdr(sl,"SYMPTOM 2",          cols.s2,   hy, cw.s2,   0.3, "1A3A6B");
  hdr(sl,"SYMPTOM 3",          cols.s3,   hy, cw.s3,   0.3, "1A3A6B");
  hdr(sl,"ADDITIONAL SIGNS",   cols.extra,hy, cw.extra, 0.3, "0D2B4A");

  const rows = [
    {
      name:"Beck's Triad", dx:"CARDIAC TAMPONADE",
      s1:"Muffled / distant heart sounds",
      s2:"Distended neck veins (raised JVP)",
      s3:"Hypotension (↓BP)",
      extra:"Pulsus paradoxus >10 mmHg · Tachycardia · Dyspnoea · Chest pain · Kussmaul sign · Friction rub (early) · Echocardiography confirms",
      nc:C.red, flag:"🚨 EMERGENCY"
    },
    {
      name:"Cushing's Triad", dx:"RAISED ICP (Impending Herniation)",
      s1:"Hypertension (widened pulse pressure)",
      s2:"Bradycardia (reflex vagal)",
      s3:"Irregular respirations (Cheyne-Stokes)",
      extra:"Papilloedema · Fixed dilated pupil · Altered GCS · Vomiting (projectile) · Headache (worse AM) · Decerebrate posturing · Impending tonsillar herniation",
      nc:C.red, flag:"🚨 EMERGENCY"
    },
    {
      name:"Triad of Aortic Stenosis", dx:"AORTIC STENOSIS",
      s1:"Angina (exertional chest pain)",
      s2:"Syncope (exertional)",
      s3:"Heart failure (dyspnoea)",
      extra:"Harsh ejection systolic murmur · Slow-rising pulse · Narrow pulse pressure · Heaving apex · Ejection click · Calcified valve on echo · Mean survival: angina 5yr, syncope 3yr, HF 2yr",
      nc:C.orange, flag:""
    },
    {
      name:"Pheochromocytoma Triad", dx:"PHAEOCHROMOCYTOMA",
      s1:"Headache (severe, pulsating)",
      s2:"Diaphoresis (profuse sweating)",
      s3:"Palpitations / tachycardia",
      extra:"Hypertensive crisis · Pallor · Anxiety/panic · Hyperglycaemia · Weight loss · Elevated urinary catecholamines · VMA/metanephrines in urine · Adrenal mass on CT",
      nc:C.orange, flag:""
    },
    {
      name:"Carcinoid Triad", dx:"CARCINOID SYNDROME",
      s1:"Episodic flushing (skin redness)",
      s2:"Secretory diarrhoea",
      s3:"Right-sided heart failure (tricuspid/pulmonary valve lesions)",
      extra:"Bronchospasm · Wheezing · Hepatomegaly (liver mets) · Elevated 5-HIAA urine · Serotonin responsible · Carcinoid crisis risk during surgery · Octreotide for treatment",
      nc:C.orange, flag:""
    },
    {
      name:"Lethal Triad (Trauma)", dx:"TRAUMA — IMMINENT DEATH",
      s1:"Hypothermia (<35°C)",
      s2:"Coagulopathy (↑PT/aPTT, ↓platelets)",
      s3:"Metabolic acidosis (↓pH, ↑lactate)",
      extra:"Each element worsens the others (vicious cycle) · Treat with damage control resuscitation · Massive transfusion protocol · Warm blood products · 1:1:1 pRBC:FFP:Plt · Target pH >7.35",
      nc:C.red, flag:"🚨 EMERGENCY"
    },
    {
      name:"Ruptured AAA Triad", dx:"RUPTURED AORTIC ANEURYSM",
      s1:"Severe abdominal / back pain (tearing)",
      s2:"Hypotension / shock",
      s3:"Pulsatile abdominal mass",
      extra:"Pain may radiate to groin/flank · May mimic renal colic · Haematuria possible · Retroperitoneal haematoma · CT angiography if stable · Emergency repair if unstable · High mortality without surgery",
      nc:C.red, flag:"🚨 EMERGENCY"
    },
  ];

  rows.forEach((r, i) => {
    const y = 0.76 + i * 0.91;
    const rh = 0.88;
    const alt = i%2===0 ? C.card : C.panel;

    // Name cell with color tag
    sl.addShape("rect",{x:cols.name,y,w:cw.name,h:rh,fill:{color:alt},line:{color:C.border}});
    sl.addShape("rect",{x:cols.name,y,w:0.18,h:rh,fill:{color:r.nc},line:{color:r.nc}});
    sl.addText(r.name,{x:cols.name+0.22,y:y+0.02,w:cw.name-0.28,h:0.28,
      fontSize:9,bold:true,color:C.gold,margin:0});
    if(r.flag) sl.addText(r.flag,{x:cols.name+0.22,y:y+0.3,w:cw.name-0.28,h:0.2,
      fontSize:7.5,bold:true,color:C.red,margin:0});

    cell(sl, r.dx, cols.dx, y, cw.dx, rh, {bg:alt, fc:C.silver, fs:8, bold:true});
    cell(sl, r.s1, cols.s1, y, cw.s1, rh, {bg:alt, fc:C.white,  fs:8.5});
    cell(sl, r.s2, cols.s2, y, cw.s2, rh, {bg:alt, fc:C.white,  fs:8.5});
    cell(sl, r.s3, cols.s3, y, cw.s3, rh, {bg:alt, fc:C.white,  fs:8.5});
    cell(sl, r.extra, cols.extra, y, cw.extra, rh, {bg:alt, fc:C.silver, fs:7.5, italic:true});
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
//  SLIDE 3 — NEUROLOGY TRIADS
// ═══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  bg(sl);

  sl.addShape("rect",{x:0,y:0,w:13.3,h:0.38,fill:{color:C.teal},line:{color:C.teal}});
  sl.addText("🧠  NEUROLOGY TRIADS — Comparison Table",{
    x:0.15,y:0,w:13,h:0.38,fontSize:13,bold:true,color:C.white,valign:"middle",charSpacing:1,margin:0});

  const cols = { name:0.12, dx:3.2, s1:5.1, s2:7.1, s3:9.1, extra:11.1 };
  const cw   = { name:3.06, dx:1.88, s1:1.98, s2:1.98, s3:1.98, extra:2.18 };
  const hy = 0.42;

  hdr(sl,"TRIAD NAME",       cols.name, hy, cw.name,  0.3, C.teal);
  hdr(sl,"DIAGNOSIS",        cols.dx,   hy, cw.dx,    0.3, "0D5F62");
  hdr(sl,"SYMPTOM 1",        cols.s1,   hy, cw.s1,    0.3, "1A3A6B");
  hdr(sl,"SYMPTOM 2",        cols.s2,   hy, cw.s2,    0.3, "1A3A6B");
  hdr(sl,"SYMPTOM 3",        cols.s3,   hy, cw.s3,    0.3, "1A3A6B");
  hdr(sl,"ADDITIONAL SIGNS", cols.extra,hy, cw.extra,  0.3, "0D2B4A");

  const rows = [
    {
      name:"Charcot's Neurological Triad", dx:"MULTIPLE SCLEROSIS",
      s1:"Scanning/staccato speech (dysarthria)",
      s2:"Intention tremor (cerebellar)",
      s3:"Nystagmus (horizontal)",
      extra:"Optic neuritis (↓visual acuity, Marcus Gunn pupil) · Uhthoff's phenomenon (worsens with heat) · Internuclear ophthalmoplegia · Lhermitte's sign · Fatigue · MRI: periventricular plaques · CSF: oligoclonal bands",
      nc:C.teal
    },
    {
      name:"Wernicke's Encephalopathy Triad", dx:"THIAMINE (B1) DEFICIENCY",
      s1:"Confusion / delirium (global confusion)",
      s2:"Ophthalmoplegia (bilateral lateral rectus palsy, conjugate gaze palsy)",
      s3:"Ataxia (gait — wide-based, cerebellar)",
      extra:"Seen in alcoholics, malnourished, hyperemesis gravidarum · If untreated → Korsakoff syndrome (anterograde amnesia + confabulation) · Treat URGENTLY: IV thiamine before glucose · Full triad in only 10-16%",
      nc:C.teal
    },
    {
      name:"Hakim's Triad (NPH)", dx:"NORMAL PRESSURE HYDROCEPHALUS",
      s1:"Gait disturbance (magnetic gait — 'Wet, Wobbly')",
      s2:"Urinary incontinence ('Wet')",
      s3:"Dementia / cognitive decline ('Wacky')",
      extra:"Gait disturbance appears FIRST · CT/MRI: dilated ventricles disproportionate to cortical atrophy · LP test: improvement after CSF drainage · Treatment: VP shunt · Normal opening CSF pressure on LP · Treatable cause of dementia",
      nc:C.teal
    },
    {
      name:"Horner's Syndrome Triad", dx:"SYMPATHETIC CHAIN INTERRUPTION",
      s1:"Ptosis (drooping upper eyelid — partial)",
      s2:"Miosis (constricted pupil — anisocoria)",
      s3:"Anhidrosis (loss of sweating — ipsilateral face)",
      extra:"Also: enophthalmos (apparent) · Causes: Pancoast tumour, carotid dissection, brainstem stroke, syringomyelia, neuroblastoma · Cocaine test: pupil doesn't dilate in Horner's · Hydroxyamphetamine test localises lesion",
      nc:C.purple
    },
    {
      name:"Botulism Triad", dx:"CLOSTRIDIUM BOTULINUM TOXIN",
      s1:"Absence of fever (afebrile)",
      s2:"Clear sensorium (alert, orientated)",
      s3:"Symmetric DESCENDING flaccid paralysis starting with cranial nerves (ptosis, diplopia, dysarthria, dysphagia → respiratory failure)",
      extra:"Autonomic features: dry mouth, blurred vision, constipation, urinary retention · Nausea/vomiting (food-borne) · Anti-toxin administration · ICU + ventilatory support · Differentials: GBS (ascending), myasthenia gravis",
      nc:C.blue
    },
    {
      name:"Opioid Overdose Triad", dx:"OPIOID TOXICITY",
      s1:"Pinpoint pupils (bilateral miosis)",
      s2:"CNS depression / unconsciousness",
      s3:"Respiratory depression (↓RR, shallow breathing)",
      extra:"Cyanosis · Bradycardia · Hypothermia · Bradypnoea (<12 breaths/min) · Naloxone (IV/IM/intranasal) reverses all features · Short half-life of naloxone → repeat dosing needed · Pulmonary oedema in severe cases",
      nc:C.red
    },
  ];

  rows.forEach((r,i) => {
    const y = 0.76 + i * 0.92;
    const rh = 0.89;
    const alt = i%2===0 ? C.card : C.panel;
    sl.addShape("rect",{x:cols.name,y,w:cw.name,h:rh,fill:{color:alt},line:{color:C.border}});
    sl.addShape("rect",{x:cols.name,y,w:0.18,h:rh,fill:{color:r.nc},line:{color:r.nc}});
    sl.addText(r.name,{x:cols.name+0.22,y:y+0.02,w:cw.name-0.28,h:0.28,fontSize:9,bold:true,color:C.gold,margin:0});
    cell(sl, r.dx,    cols.dx,    y, cw.dx,    rh, {bg:alt,fc:C.silver,fs:8,bold:true});
    cell(sl, r.s1,    cols.s1,    y, cw.s1,    rh, {bg:alt,fc:C.white, fs:8.5});
    cell(sl, r.s2,    cols.s2,    y, cw.s2,    rh, {bg:alt,fc:C.white, fs:8.5});
    cell(sl, r.s3,    cols.s3,    y, cw.s3,    rh, {bg:alt,fc:C.white, fs:8.5});
    cell(sl, r.extra, cols.extra, y, cw.extra, rh, {bg:alt,fc:C.silver,fs:7.5,italic:true});
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
//  SLIDE 4 — GASTROENTEROLOGY / HEPATOLOGY TRIADS
// ═══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  bg(sl);

  sl.addShape("rect",{x:0,y:0,w:13.3,h:0.38,fill:{color:C.green},line:{color:C.green}});
  sl.addText("🫀  GASTROENTEROLOGY & HEPATOLOGY TRIADS — Comparison Table",{
    x:0.15,y:0,w:13,h:0.38,fontSize:13,bold:true,color:C.white,valign:"middle",charSpacing:1,margin:0});

  const cols = {name:0.12,dx:3.2,s1:5.1,s2:7.1,s3:9.1,extra:11.1};
  const cw   = {name:3.06,dx:1.88,s1:1.98,s2:1.98,s3:1.98,extra:2.18};
  const hy=0.42;
  hdr(sl,"TRIAD NAME",       cols.name,hy,cw.name,0.3,C.green);
  hdr(sl,"DIAGNOSIS",        cols.dx,  hy,cw.dx,  0.3,"145A2E");
  hdr(sl,"SYMPTOM 1",        cols.s1,  hy,cw.s1,  0.3,"1A3A6B");
  hdr(sl,"SYMPTOM 2",        cols.s2,  hy,cw.s2,  0.3,"1A3A6B");
  hdr(sl,"SYMPTOM 3",        cols.s3,  hy,cw.s3,  0.3,"1A3A6B");
  hdr(sl,"ADDITIONAL SIGNS", cols.extra,hy,cw.extra,0.3,"0D2B4A");

  const rows = [
    {
      name:"Charcot's Cholangitis Triad", dx:"ASCENDING CHOLANGITIS",
      s1:"Right upper quadrant pain (biliary colic)",
      s2:"Fever with rigors / chills",
      s3:"Jaundice (obstructive — pale stools, dark urine)",
      extra:"Present in ~70% · Reynolds' Pentad adds: confusion + hypotension (septic shock) → immediate intervention · Blood cultures · IV antibiotics · ERCP for decompression · LFTs: raised ALP/GGT/bilirubin · Gallstone most common cause",
      nc:C.green, flag:"🚨 EMERGENCY"
    },
    {
      name:"Budd-Chiari Syndrome Triad", dx:"HEPATIC VEIN THROMBOSIS",
      s1:"Abdominal pain (acute, RUQ/diffuse)",
      s2:"Ascites (massive, rapid-onset)",
      s3:"Hepatomegaly (tender)",
      extra:"Splenomegaly · Jaundice · Varices · Liver biopsy: centrilobular necrosis, congestion · US Doppler: absent/reversed hepatic vein flow · Associated with hypercoagulable states, OCP, polycythaemia vera · Treatment: anticoagulation, TIPS, transplant",
      nc:C.green
    },
    {
      name:"Acute Liver Failure Triad", dx:"ACUTE LIVER FAILURE",
      s1:"Jaundice (rapidly deepening)",
      s2:"Coagulopathy (↑PT/INR, bleeding)",
      s3:"Hepatic encephalopathy (confusion → coma)",
      extra:"Cerebral oedema · Hypoglycaemia · Renal failure · Infections · Coagulopathy: PT/INR > 1.5 · Causes: paracetamol OD (#1), viral hepatitis, Wilson's disease, Amanita phalloides · N-acetylcysteine for paracetamol · Transplant assessment",
      nc:C.green
    },
    {
      name:"Whipple's Triad", dx:"INSULINOMA",
      s1:"Hypoglycaemic symptoms during fasting/exercise (sweating, tremor, confusion)",
      s2:"Documented low blood glucose (<2.2 mmol/L during attack)",
      s3:"Complete relief of symptoms with glucose administration",
      extra:"Sympathetic: sweating, palpitations, tremor, hunger · Neuroglycopenic: confusion, seizures, coma · 72-hour fast test for diagnosis · CT/MRI: pancreatic mass · Elevated insulin:glucose ratio · Elevated C-peptide · Surgery is curative",
      nc:C.gold
    },
    {
      name:"Rigler's Triad", dx:"GALLSTONE ILEUS",
      s1:"Gallstones (history of cholelithiasis)",
      s2:"Pneumobilia (air in bile ducts on X-ray/CT)",
      s3:"Small bowel obstruction (dilated loops, air-fluid levels)",
      extra:"Large gallstone erodes through cholecystoduodenal fistula · Ectopic gallstone in terminal ileum (commonest site) · Ectopic stone at Bouveret's level (duodenum) · CT is investigation of choice · Treatment: enterolithotomy · Older female patients",
      nc:C.green
    },
    {
      name:"Achalasia Triad", dx:"ACHALASIA (OESOPHAGEAL)",
      s1:"Dysphagia (progressive — both solids AND liquids)",
      s2:"Regurgitation (undigested food)",
      s3:"Weight loss (progressive)",
      extra:"Nocturnal regurgitation · Aspiration pneumonia · Retrosternal chest pain (early) · Manometry: ↑LES pressure + absent peristalsis (GOLD STANDARD) · Barium swallow: 'bird-beak' sign · Heller's myotomy or pneumatic dilation",
      nc:C.green
    },
    {
      name:"Borchardt's Triad", dx:"ACUTE GASTRIC VOLVULUS",
      s1:"Severe epigastric pain (sudden onset)",
      s2:"Retching without vomiting (unproductive vomiting)",
      s3:"Inability to pass nasogastric tube",
      extra:"Associated with diaphragmatic hernia · Gaseous distension of stomach · CXR: gas-filled viscus in chest · Often elderly females · Prone to strangulation and infarction · Gastroscopy often impossible · Emergency surgery required",
      nc:C.red, flag:"🚨 EMERGENCY"
    },
  ];

  rows.forEach((r,i) => {
    const y = 0.76 + i * 0.91;
    const rh = 0.88;
    const alt = i%2===0 ? C.card : C.panel;
    sl.addShape("rect",{x:cols.name,y,w:cw.name,h:rh,fill:{color:alt},line:{color:C.border}});
    sl.addShape("rect",{x:cols.name,y,w:0.18,h:rh,fill:{color:r.nc},line:{color:r.nc}});
    sl.addText(r.name,{x:cols.name+0.22,y:y+0.02,w:cw.name-0.28,h:0.28,fontSize:9,bold:true,color:C.gold,margin:0});
    if(r.flag) sl.addText(r.flag,{x:cols.name+0.22,y:y+0.3,w:cw.name-0.28,h:0.2,fontSize:7.5,bold:true,color:C.red,margin:0});
    cell(sl,r.dx,    cols.dx,    y,cw.dx,    rh,{bg:alt,fc:C.silver,fs:8,bold:true});
    cell(sl,r.s1,    cols.s1,    y,cw.s1,    rh,{bg:alt,fc:C.white, fs:8.5});
    cell(sl,r.s2,    cols.s2,    y,cw.s2,    rh,{bg:alt,fc:C.white, fs:8.5});
    cell(sl,r.s3,    cols.s3,    y,cw.s3,    rh,{bg:alt,fc:C.white, fs:8.5});
    cell(sl,r.extra, cols.extra, y,cw.extra, rh,{bg:alt,fc:C.silver,fs:7.5,italic:true});
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
//  SLIDE 5 — INFECTIOUS, RHEUMATOLOGY & NEPHROLOGY TRIADS
// ═══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  bg(sl);

  sl.addShape("rect",{x:0,y:0,w:13.3,h:0.38,fill:{color:C.blue},line:{color:C.blue}});
  sl.addText("🦠  INFECTIOUS DISEASE · RHEUMATOLOGY · NEPHROLOGY TRIADS",{
    x:0.15,y:0,w:13,h:0.38,fontSize:13,bold:true,color:C.white,valign:"middle",charSpacing:1,margin:0});

  const cols={name:0.12,dx:3.2,s1:5.1,s2:7.1,s3:9.1,extra:11.1};
  const cw  ={name:3.06,dx:1.88,s1:1.98,s2:1.98,s3:1.98,extra:2.18};
  const hy=0.42;
  hdr(sl,"TRIAD NAME",       cols.name,hy,cw.name,0.3,C.blue);
  hdr(sl,"DIAGNOSIS",        cols.dx,  hy,cw.dx,  0.3,"0D3B6E");
  hdr(sl,"SYMPTOM 1",        cols.s1,  hy,cw.s1,  0.3,"1A3A6B");
  hdr(sl,"SYMPTOM 2",        cols.s2,  hy,cw.s2,  0.3,"1A3A6B");
  hdr(sl,"SYMPTOM 3",        cols.s3,  hy,cw.s3,  0.3,"1A3A6B");
  hdr(sl,"ADDITIONAL SIGNS", cols.extra,hy,cw.extra,0.3,"0D2B4A");

  const rows = [
    {
      name:"Weil's Disease Triad (Leptospirosis)", dx:"LEPTOSPIROSIS (Weil disease)",
      s1:"Meningitis (severe headache, neck stiffness, photophobia)",
      s2:"Liver damage (jaundice, elevated LFTs, haemorrhage)",
      s3:"Renal dysfunction (AKI, oliguria, uraemia)",
      extra:"Biphasic illness: 1st phase — flu-like (4-7 days) → 2nd phase (immune): Weil triad · Conjunctival suffusion (hallmark) · Leptospiraemia → serology/PCR diagnosis · Penicillin/doxycycline · Rodent urine exposure",
      nc:C.blue
    },
    {
      name:"Reactive Arthritis Triad (Reiter's)", dx:"REACTIVE ARTHRITIS",
      s1:"Conjunctivitis / uveitis ('Can't SEE')",
      s2:"Urethritis / cervicitis ('Can't PEE')",
      s3:"Arthritis — asymmetric, large joints ('Can't climb a TREE')",
      extra:"Also: mouth ulcers · Keratoderma blennorrhagica (soles) · Circinate balanitis · Triggered by Chlamydia (STI) or enteric infection (Salmonella/Shigella/Campylobacter) · HLA-B27 positive · NSAIDs + physiotherapy",
      nc:C.purple
    },
    {
      name:"Behcet's Disease Triad", dx:"BEHCET'S DISEASE",
      s1:"Recurrent oral aphthous ulcers (painful, multiple, ≥3×/year)",
      s2:"Genital ulcers (painful, scarring)",
      s3:"Iridocyclitis / uveitis (anterior or posterior)",
      extra:"Pathergy test positive · Skin lesions (pseudofolliculitis, erythema nodosum) · Large vessel vasculitis (DVT, Budd-Chiari) · Neurological involvement · Common in 'Silk Road' countries · Colchicine for mucocutaneous disease · Immunosuppressants for eye/CNS",
      nc:C.purple
    },
    {
      name:"AIN Triad (Acute Interstitial Nephritis)", dx:"ACUTE INTERSTITIAL NEPHRITIS",
      s1:"Fever",
      s2:"Maculopapular rash",
      s3:"Peripheral eosinophilia",
      extra:"All 3 present in only 10% of cases · AKI (↑creatinine) · Eosinophiluria on urine dipstick · Drugs: NSAIDs, PPIs, beta-lactam antibiotics, sulfonamides · Sterile pyuria · White cell casts · Renal biopsy confirms · Steroids if drug-related",
      nc:"1A8A9A"
    },
    {
      name:"Austrian Syndrome Triad", dx:"AUSTRIAN SYNDROME (S. pneumoniae)",
      s1:"Pneumonia (lobar consolidation)",
      s2:"Endocarditis (new murmur, vegetations)",
      s3:"Meningitis (neck stiffness, photophobia, altered GCS)",
      extra:"All three from S. pneumoniae · Blood cultures + Echo + LP · Penicillin G treatment · High mortality · Associated alcoholism/asplenia · Aortic valve most commonly affected · Simultaneous seeding via bacteraemia",
      nc:C.blue
    },
    {
      name:"Congenital Rubella Triad (Gregg's)", dx:"CONGENITAL RUBELLA SYNDROME",
      s1:"Cataracts (bilateral nuclear cataracts)",
      s2:"Patent ductus arteriosus (continuous machinery murmur)",
      s3:"Sensorineural hearing loss (bilateral)",
      extra:"Also: microcephaly · Microphthalmia · 'Blueberry muffin' rash (dermal haematopoiesis) · Cardiac defects: PDA, VSD, pulmonary artery stenosis · Rubella IgM titre · Prevention: MMR vaccine pre-pregnancy",
      nc:C.blue
    },
    {
      name:"Congenital Toxoplasmosis Triad (Sabin's)", dx:"CONGENITAL TOXOPLASMOSIS",
      s1:"Chorioretinitis (retinochoroiditis — visual impairment, squint)",
      s2:"Hydrocephalus (large head circumference, bulging fontanelle)",
      s3:"Intracranial calcifications (periventricular, on CT skull)",
      extra:"Also: psychomotor retardation · Seizures · Microcephaly · Toxoplasma gondii (cat faeces) · Maternal infection in 3rd trimester → worst fetal outcome · IgG avidity + PCR of amniotic fluid · Pyrimethamine + sulphadiazine",
      nc:C.blue
    },
  ];

  rows.forEach((r,i) => {
    const y = 0.76 + i * 0.91;
    const rh = 0.88;
    const alt = i%2===0 ? C.card : C.panel;
    sl.addShape("rect",{x:cols.name,y,w:cw.name,h:rh,fill:{color:alt},line:{color:C.border}});
    sl.addShape("rect",{x:cols.name,y,w:0.18,h:rh,fill:{color:r.nc},line:{color:r.nc}});
    sl.addText(r.name,{x:cols.name+0.22,y:y+0.02,w:cw.name-0.28,h:0.28,fontSize:9,bold:true,color:C.gold,margin:0});
    cell(sl,r.dx,    cols.dx,    y,cw.dx,    rh,{bg:alt,fc:C.silver,fs:8,bold:true});
    cell(sl,r.s1,    cols.s1,    y,cw.s1,    rh,{bg:alt,fc:C.white, fs:8.5});
    cell(sl,r.s2,    cols.s2,    y,cw.s2,    rh,{bg:alt,fc:C.white, fs:8.5});
    cell(sl,r.s3,    cols.s3,    y,cw.s3,    rh,{bg:alt,fc:C.white, fs:8.5});
    cell(sl,r.extra, cols.extra, y,cw.extra, rh,{bg:alt,fc:C.silver,fs:7.5,italic:true});
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
//  SLIDE 6 — ENDOCRINE · OB/GYN · ORTHO · ENT · MISC
// ═══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  bg(sl);

  sl.addShape("rect",{x:0,y:0,w:13.3,h:0.38,fill:{color:C.gold},line:{color:C.gold}});
  sl.addText("💊  ENDOCRINE · OB/GYN · ORTHOPAEDICS · ENT · RESPIRATORY — Comparison Table",{
    x:0.15,y:0,w:13,h:0.38,fontSize:13,bold:true,color:C.bg,valign:"middle",charSpacing:1,margin:0});

  const cols={name:0.12,dx:3.2,s1:5.1,s2:7.1,s3:9.1,extra:11.1};
  const cw  ={name:3.06,dx:1.88,s1:1.98,s2:1.98,s3:1.98,extra:2.18};
  const hy=0.42;
  hdr(sl,"TRIAD NAME",       cols.name,hy,cw.name,0.3,"8A6800");
  hdr(sl,"DIAGNOSIS",        cols.dx,  hy,cw.dx,  0.3,"5A4200");
  hdr(sl,"SYMPTOM 1",        cols.s1,  hy,cw.s1,  0.3,"1A3A6B");
  hdr(sl,"SYMPTOM 2",        cols.s2,  hy,cw.s2,  0.3,"1A3A6B");
  hdr(sl,"SYMPTOM 3",        cols.s3,  hy,cw.s3,  0.3,"1A3A6B");
  hdr(sl,"ADDITIONAL SIGNS", cols.extra,hy,cw.extra,0.3,"0D2B4A");

  const rows = [
    {
      name:"Pellagra Triad (3 D's)", dx:"PELLAGRA — NIACIN (B3) DEFICIENCY",
      s1:"Dermatitis (Casal's necklace — sun-exposed photosensitive rash)",
      s2:"Diarrhoea (watery, bloody — GI mucosal damage)",
      s3:"Dementia / neuropsychiatric symptoms (depression, psychosis, confusion)",
      extra:"4th D = Death (if untreated) · Also: glossitis, stomatitis, hyperpigmentation · Common in maize-eating populations, alcoholics, isoniazid use · Nicotinamide treatment · Hartnup disease (tryptophan malabsorption) as cause",
      nc:"D4A017"
    },
    {
      name:"Pre-eclampsia Triad", dx:"PRE-ECLAMPSIA",
      s1:"Hypertension (≥140/90 mmHg after 20 weeks)",
      s2:"Proteinuria (≥300 mg/24h, or dipstick ≥++)",
      s3:"Oedema (especially face, hands — sudden pitting)",
      extra:"Headache · Visual disturbances (scotomata) · Epigastric pain (liver capsule stretch) · ↑Uric acid · ↑Creatinine · HELLP syndrome (Haemolysis + Elevated LFTs + Low Platelets) · Delivery is definitive treatment · MgSO4 for seizure prophylaxis",
      nc:C.pink
    },
    {
      name:"Ectopic Pregnancy Triad", dx:"ECTOPIC PREGNANCY",
      s1:"Amenorrhoea (missed period — 6-8 weeks LMP)",
      s2:"Abdominal pain (unilateral, lower quadrant — may be sudden/severe if ruptured)",
      s3:"Vaginal bleeding (dark brown, irregular spotting)",
      extra:"Shoulder-tip pain (if ruptured — diaphragmatic irritation by blood) · Cervical excitation on PV exam · ↑βhCG but below expected for dates · TV USS: no IUP, adnexal mass · Risk factors: PID, previous ectopic, IUD, IVF · Methotrexate or salpingectomy",
      nc:C.pink, flag:"🚨 EMERGENCY if ruptured"
    },
    {
      name:"Unhappy Triad (O'Donoghue's)", dx:"KNEE INJURY (Blown Knee)",
      s1:"ACL tear (anterior cruciate — Lachman test positive)",
      s2:"MCL tear (medial collateral — valgus stress test positive)",
      s3:"Medial/lateral meniscus tear (McMurray test positive)",
      extra:"Mechanism: valgus + rotation force (contact sports) · Haemarthrosis (rapid swelling within hours) · MRI is investigation of choice · Reconstruction: ACL graft + meniscal repair · Associated with high-level sport · Medial meniscus more common in classic description",
      nc:C.lime
    },
    {
      name:"Samter's Triad (Aspirin Triad)", dx:"ASPIRIN-EXACERBATED RESPIRATORY DISEASE",
      s1:"Aspirin / NSAID sensitivity (bronchospasm within 30-60 min of ingestion)",
      s2:"Nasal polyps (bilateral, eosinophilic)",
      s3:"Asthma (often severe, steroid-dependent)",
      extra:"Also: chronic rhinosinusitis · Eosinophilic airway inflammation · Arachidonic acid pathway: ↑LTC4/D4/E4 leukotrienes · COX-1 inhibitors all trigger · Avoid aspirin/NSAIDs · Leukotriene receptor antagonists helpful · Aspirin desensitisation possible",
      nc:C.teal
    },
    {
      name:"Meniere's Disease Triad", dx:"MENIERE'S DISEASE",
      s1:"Episodic vertigo (rotational, severe, spontaneous — 20 min to 12 hrs)",
      s2:"Tinnitus (low-frequency roaring, worsens during attacks)",
      s3:"Sensorineural hearing loss (unilateral, fluctuating, low-frequency early)",
      extra:"Aural fullness (4th hallmark) · Endolymphatic hydrops on MRI (gadolinium) · Caloric testing: reduced vestibular response · Audiogram: low-frequency notch · Low-salt diet + betahistine · Intratympanic gentamicin or steroids · Endolymphatic sac surgery",
      nc:C.cyan
    },
    {
      name:"Leriche Syndrome Triad", dx:"AORTOILIAC OCCLUSIVE DISEASE",
      s1:"Buttock/thigh claudication (bilateral, exertional)",
      s2:"Erectile dysfunction (impotence — loss of pelvic blood flow)",
      s3:"Symmetrical atrophy of both lower extremities",
      extra:"Cool, pale limbs · Absent femoral pulses bilaterally · ABI <0.9 · CT angiography confirms occlusion at aortic bifurcation · Risk factors: smoking (#1), diabetes, dyslipidaemia · Aortobifemoral bypass or endovascular stenting",
      nc:C.orange
    },
  ];

  rows.forEach((r,i) => {
    const y = 0.76 + i * 0.91;
    const rh = 0.88;
    const alt = i%2===0 ? C.card : C.panel;
    sl.addShape("rect",{x:cols.name,y,w:cw.name,h:rh,fill:{color:alt},line:{color:C.border}});
    sl.addShape("rect",{x:cols.name,y,w:0.18,h:rh,fill:{color:r.nc},line:{color:r.nc}});
    sl.addText(r.name,{x:cols.name+0.22,y:y+0.02,w:cw.name-0.28,h:0.28,fontSize:9,bold:true,color:C.gold,margin:0});
    if(r.flag) sl.addText(r.flag,{x:cols.name+0.22,y:y+0.3,w:cw.name-0.28,h:0.2,fontSize:7,bold:true,color:C.red,margin:0});
    cell(sl,r.dx,    cols.dx,    y,cw.dx,    rh,{bg:alt,fc:C.silver,fs:8,bold:true});
    cell(sl,r.s1,    cols.s1,    y,cw.s1,    rh,{bg:alt,fc:C.white, fs:8.5});
    cell(sl,r.s2,    cols.s2,    y,cw.s2,    rh,{bg:alt,fc:C.white, fs:8.5});
    cell(sl,r.s3,    cols.s3,    y,cw.s3,    rh,{bg:alt,fc:C.white, fs:8.5});
    cell(sl,r.extra, cols.extra, y,cw.extra, rh,{bg:alt,fc:C.silver,fs:7.5,italic:true});
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
//  SLIDE 7 — QUICK-FIRE CHEAT SHEET (MNEMONICS + FLASHCARD GRID)
// ═══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  bg(sl);
  sl.addShape("rect",{x:0,y:0,w:13.3,h:0.42,fill:{color:"1A1A2E"},line:{color:"1A1A2E"}});
  sl.addText("⚡  QUICK-FIRE MNEMONICS & CHEAT SHEET — All Key Triads at a Glance",{
    x:0.15,y:0,w:13,h:0.42,fontSize:13,bold:true,color:C.gold,valign:"middle",charSpacing:2,margin:0});

  const cards = [
    // Row 1
    {name:"Beck's",             diag:"Cardiac Tamponade",         s:"Muffled hearts\nJVD / Neck veins up\nHypotension",        mnem:"BBB: Bag + Bulge + BP↓", c:C.red},
    {name:"Cushing's",          diag:"Raised ICP",                s:"Hypertension\nBradycardia\nIrregular respiration",       mnem:"HBO: HBP + Bradycardia + O2↓", c:C.red},
    {name:"Charcot's (biliary)",diag:"Ascending Cholangitis",     s:"RUQ Pain\nFever + Rigors\nJaundice",                    mnem:"PFJ: Pain-Fever-Jaundice", c:C.green},
    {name:"Charcot's (neuro)",  diag:"Multiple Sclerosis",        s:"Scanning speech\nIntention tremor\nNystagmus",           mnem:"SIN: Speech-Intention-Nystagmus", c:C.teal},
    {name:"Wernicke's",         diag:"Thiamine Deficiency",       s:"Confusion\nOphthalmoplegia\nAtaxia",                    mnem:"COA: Confusion-Ophthalm-Ataxia", c:C.teal},
    // Row 2
    {name:"NPH / Hakim's",      diag:"Normal Pressure Hydrocephalus",s:"Gait disturbance\nUrinary incontinence\nDementia",    mnem:"3 W's: Wobbly-Wet-Wacky", c:C.purple},
    {name:"Virchow's",          diag:"Venous Thrombosis (DVT/PE)", s:"Stasis\nHypercoagulability\nEndothelial injury",        mnem:"SHE: Stasis-Hyper-Endothelial", c:C.maroon},
    {name:"Reactive Arthritis", diag:"Reiter's Syndrome",          s:"Conjunctivitis\nUrethritis\nArthritis",                 mnem:"Can't SEE, PEE, climb a TREE", c:C.purple},
    {name:"Opioid OD",          diag:"Opioid Toxicity",            s:"Pinpoint pupils\nCNS depression\nRespiratory↓",         mnem:"PPR: Pupils-Peristalsis-Respiration", c:C.red},
    {name:"Pellagra (3 D's)",   diag:"Niacin (B3) Deficiency",    s:"Dermatitis\nDiarrhoea\nDementia",                      mnem:"3 D's + Death = 4 D's", c:"D4A017"},
    // Row 3
    {name:"Pheochromocytoma",   diag:"Phaeochromocytoma",          s:"Headache\nDiaphoresis\nPalpitations",                   mnem:"HDP: Head-Diaphoresis-Palp", c:C.orange},
    {name:"Horner's Syndrome",  diag:"Sympathetic interruption",   s:"Ptosis\nMiosis\nAnhidrosis",                           mnem:"PMA: Ptosis-Miosis-Anhidrosis", c:C.purple},
    {name:"Meniere's",          diag:"Meniere's Disease",          s:"Vertigo\nTinnitus\nHearing loss",                      mnem:"VTH: Vertigo-Tinnitus-Hearing", c:C.cyan},
    {name:"Ruptured AAA",       diag:"AAA Rupture",                s:"Abdominal pain\nHypotension/shock\nPulsatile mass",     mnem:"APP: Abdo-Pressure↓-Pulsatile", c:C.red},
    {name:"Lethal Triad",       diag:"Trauma Death",               s:"Hypothermia\nCoagulopathy\nAcidosis",                  mnem:"HCA: Hypo-Coagulo-Acidosis", c:C.red},
    // Row 4
    {name:"Boerhaave (Mackler)", diag:"Oesophageal Perforation",   s:"Vomiting\nThoracic pain\nSubcut. emphysema",            mnem:"VPS: Vomit-Pain-SubcutEmphysema", c:"C06A15"},
    {name:"Rigler's",           diag:"Gallstone Ileus",            s:"Gallstones\nPneumobilia\nSmall bowel obstruction",      mnem:"GPS: Gallstones-Pneumo-SBO", c:C.green},
    {name:"Samter's Triad",     diag:"NSAID-exacerbated Asthma",   s:"Aspirin sensitivity\nNasal polyps\nAsthma",             mnem:"ANA: Aspirin-Nasal-Asthma", c:C.teal},
    {name:"Congenital Rubella", diag:"Rubella Syndrome",           s:"Cataracts\nPDA\nDeafness",                             mnem:"CPD: Cataract-PDA-Deaf", c:C.blue},
    {name:"Aortic Stenosis",    diag:"Aortic Stenosis",            s:"Angina\nSyncope\nHeart failure",                       mnem:"ASH: Angina-Syncope-HF", c:C.orange},
  ];

  const cardsPerRow = 5;
  const cardW = 2.53;
  const cardH = 1.55;
  const startX = 0.12;
  const startY = 0.52;
  const gapX = 0.06;
  const gapY = 0.06;

  cards.forEach((card, i) => {
    const row = Math.floor(i / cardsPerRow);
    const col = i % cardsPerRow;
    const x = startX + col * (cardW + gapX);
    const y = startY + row * (cardH + gapY);

    // Card bg
    sl.addShape("rect",{x,y,w:cardW,h:cardH,fill:{color:C.card},line:{color:C.border},
      shadow:{type:"outer",color:"000000",blur:5,offset:2,angle:135,opacity:0.2}});
    // Color top bar
    sl.addShape("rect",{x,y,w:cardW,h:0.22,fill:{color:card.c},line:{color:card.c}});
    // Triad name
    sl.addText(card.name,{x:x+0.06,y:y+0.01,w:cardW-0.12,h:0.2,fontSize:8.5,bold:true,color:C.white,valign:"middle",margin:0});
    // Diagnosis
    sl.addText(card.diag,{x:x+0.06,y:y+0.22,w:cardW-0.12,h:0.22,fontSize:7.5,bold:true,color:C.gold,valign:"middle",margin:0,italic:true});
    // Symptoms
    sl.addText(card.s,{x:x+0.06,y:y+0.44,w:cardW-0.12,h:0.62,fontSize:8,color:C.white,valign:"top",margin:0,fontFace:"Calibri"});
    // Mnemonic
    sl.addShape("rect",{x:x+0.05,y:y+cardH-0.35,w:cardW-0.1,h:0.3,fill:{color:"0D1B2A"},line:{color:card.c}});
    sl.addText(card.mnem,{x:x+0.08,y:y+cardH-0.34,w:cardW-0.16,h:0.28,fontSize:7,color:card.c,bold:true,valign:"middle",margin:0,italic:true});
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
//  SLIDE 8 — COMPARISON: TRIADS WITH OVERLAPPING SYMPTOMS
// ═══════════════════════════════════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  bg(sl);

  sl.addShape("rect",{x:0,y:0,w:13.3,h:0.42,fill:{color:C.purple},line:{color:C.purple}});
  sl.addText("🔍  TRIADS WITH SIMILAR SYMPTOMS — How to Tell Them Apart",{
    x:0.15,y:0,w:13,h:0.42,fontSize:13,bold:true,color:C.white,valign:"middle",charSpacing:1,margin:0});

  // ── GROUP 1: Triads with Jaundice ──────────────────────────────────────────
  sectionTitle(sl,"GROUP 1: TRIADS INVOLVING JAUNDICE",C.green,0.12,0.5,5.5);
  const jCols = {name:0.12,s1:2.1,s2:3.85,s3:5.7,key:7.5};
  const jW    = {name:1.96,s1:1.73,s2:1.83,s3:1.78,key:1.8};
  hdr(sl,"CONDITION",jCols.name,0.82,jW.name,0.25,C.green);
  hdr(sl,"SYMPTOM 1", jCols.s1,  0.82,jW.s1,  0.25,"1A5A3A");
  hdr(sl,"SYMPTOM 2", jCols.s2,  0.82,jW.s2,  0.25,"1A5A3A");
  hdr(sl,"SYMPTOM 3", jCols.s3,  0.82,jW.s3,  0.25,"1A5A3A");
  hdr(sl,"KEY DIFF",  jCols.key, 0.82,jW.key,  0.25,"0B3B22");

  const jRows = [
    {name:"Charcot's Triad",  s1:"RUQ pain",         s2:"Fever + rigors",       s3:"Jaundice",          key:"Acute onset, gallstones, ↑ALP",c:C.green},
    {name:"Budd-Chiari",      s1:"Abdominal pain",   s2:"Ascites (massive)",    s3:"Hepatomegaly",      key:"Slow onset, no fever, Doppler↓",c:C.green},
    {name:"Acute Liver Fail", s1:"Jaundice",         s2:"Coagulopathy (↑INR)",  s3:"Encephalopathy",    key:"No pain, ↑↑PT, paracetamol Hx",c:C.green},
    {name:"Weil's Disease",   s1:"Meningitis signs", s2:"Jaundice",             s3:"Renal failure (AKI)",key:"Rodent/water exposure, biphasic",c:C.blue},
    {name:"Austrian Synd.",   s1:"Pneumonia",        s2:"Endocarditis",         s3:"Meningitis",         key:"All from S. pneumoniae, no jaundice",c:C.blue},
  ];
  jRows.forEach((r,i)=>{
    const y=1.1+i*0.44;const rh=0.42;const alt=i%2===0?C.card:C.panel;
    cell(sl,r.name,jCols.name,y,jW.name,rh,{bg:alt,fc:C.gold,fs:8.5,bold:true});
    cell(sl,r.s1,  jCols.s1,  y,jW.s1,  rh,{bg:alt,fc:C.white,fs:8});
    cell(sl,r.s2,  jCols.s2,  y,jW.s2,  rh,{bg:alt,fc:C.white,fs:8});
    cell(sl,r.s3,  jCols.s3,  y,jW.s3,  rh,{bg:alt,fc:C.white,fs:8});
    cell(sl,r.key, jCols.key, y,jW.key,  rh,{bg:alt,fc:C.gold, fs:7.5,italic:true});
  });

  // ── GROUP 2: Triads with Hypotension ─────────────────────────────────────
  sectionTitle(sl,"GROUP 2: TRIADS INVOLVING HYPOTENSION / SHOCK",C.red,0.12,3.3,5.5);
  const hRows = [
    {name:"Beck's Triad",      s1:"Muffled heart sounds",s2:"JVD / ↑JVP",      s3:"Hypotension",     key:"Pulsus paradoxus, after trauma/pericarditis"},
    {name:"Ruptured AAA",      s1:"Abdominal pain",      s2:"Hypotension",      s3:"Pulsatile mass",  key:"Elderly, smoker, absent femoral pulses"},
    {name:"Lethal Triad",      s1:"Hypothermia",         s2:"Coagulopathy",     s3:"Acidosis",        key:"Trauma context, serial ABGs/labs"},
    {name:"Botulism",          s1:"No fever (afebrile)", s2:"Clear sensorium",  s3:"Descending paralysis",key:"Food source, autonomic signs, no sensory loss"},
    {name:"Opioid OD",         s1:"Pinpoint pupils",     s2:"CNS depression",   s3:"Resp. depression",key:"Naloxone reversal, drug context"},
  ];
  hRows.forEach((r,i)=>{
    const y=3.58+i*0.44;const rh=0.42;const alt=i%2===0?C.card:C.panel;
    cell(sl,r.name,jCols.name,y,jW.name,rh,{bg:alt,fc:C.gold,fs:8.5,bold:true});
    cell(sl,r.s1,  jCols.s1,  y,jW.s1,  rh,{bg:alt,fc:C.white,fs:8});
    cell(sl,r.s2,  jCols.s2,  y,jW.s2,  rh,{bg:alt,fc:C.white,fs:8});
    cell(sl,r.s3,  jCols.s3,  y,jW.s3,  rh,{bg:alt,fc:C.white,fs:8});
    cell(sl,r.key, jCols.key, y,jW.key,  rh,{bg:alt,fc:C.gold, fs:7.5,italic:true});
  });

  // ── GROUP 3: NEUROLOGICAL ─────────────────────────────────────────────────
  sectionTitle(sl,"GROUP 3: NEUROLOGICAL TRIADS",C.teal,7.1,0.5,6.1);
  const nCols={name:7.1,s1:8.9,s2:10.55,s3:12.15};
  const nW  ={name:1.78,s1:1.63,s2:1.58,s3:1.15};
  hdr(sl,"CONDITION",nCols.name,0.82,nW.name,0.25,C.teal);
  hdr(sl,"SYMPTOM 1", nCols.s1,  0.82,nW.s1,  0.25,"0D5F62");
  hdr(sl,"SYMPTOM 2", nCols.s2,  0.82,nW.s2,  0.25,"0D5F62");
  hdr(sl,"SYMPTOM 3", nCols.s3,  0.82,nW.s3,  0.25,"0D5F62");

  const nRows = [
    {name:"Charcot (neuro)",s1:"Scanning speech",    s2:"Intention tremor",   s3:"Nystagmus",         c:C.teal},
    {name:"Wernicke's",     s1:"Confusion",          s2:"Ophthalmoplegia",    s3:"Ataxia",            c:C.teal},
    {name:"NPH / Hakim's",  s1:"Gait disturbance",   s2:"Incontinence",       s3:"Dementia",          c:C.teal},
    {name:"Horner's",       s1:"Ptosis (partial)",   s2:"Miosis (anisocoria)",s3:"Anhidrosis (face)", c:C.purple},
    {name:"Cushing's",      s1:"Hypertension",       s2:"Bradycardia",        s3:"Irreg. respiration",c:C.red},
    {name:"Botulism",       s1:"No fever",           s2:"Clear sensorium",    s3:"Descend. paralysis",c:C.blue},
    {name:"Opioid OD",      s1:"Pinpoint pupils",    s2:"CNS depression",     s3:"Resp. depression",  c:C.red},
  ];
  nRows.forEach((r,i)=>{
    const y=1.1+i*0.44;const rh=0.42;const alt=i%2===0?C.card:C.panel;
    sl.addShape("rect",{x:nCols.name,y,w:nW.name,h:rh,fill:{color:alt},line:{color:C.border}});
    sl.addShape("rect",{x:nCols.name,y,w:0.14,h:rh,fill:{color:r.c},line:{color:r.c}});
    sl.addText(r.name,{x:nCols.name+0.17,y:y+0.06,w:nW.name-0.2,h:0.3,fontSize:8.5,bold:true,color:C.gold,margin:0});
    cell(sl,r.s1,nCols.s1,y,nW.s1,rh,{bg:alt,fc:C.white,fs:8});
    cell(sl,r.s2,nCols.s2,y,nW.s2,rh,{bg:alt,fc:C.white,fs:8});
    cell(sl,r.s3,nCols.s3,y,nW.s3,rh,{bg:alt,fc:C.white,fs:8});
  });

  // ── GROUP 4: Congenital ────────────────────────────────────────────────────
  sectionTitle(sl,"GROUP 4: CONGENITAL TRIADS",C.blue,7.1,4.22,6.1);
  const conRows = [
    {name:"Congenital Rubella",    s1:"Cataracts",             s2:"PDA",                s3:"Sensorineural deafness"},
    {name:"Congenital Toxoplasma", s1:"Chorioretinitis",       s2:"Hydrocephalus",      s3:"Intracranial calcifications"},
    {name:"Congenital Syphilis",   s1:"Interstitial keratitis",s2:"Hutchinson's teeth", s3:"8th nerve deafness (Hutchinson's Triad)"},
  ];
  conRows.forEach((r,i)=>{
    const y=4.5+i*0.44;const rh=0.42;const alt=i%2===0?C.card:C.panel;
    sl.addShape("rect",{x:nCols.name,y,w:nW.name,h:rh,fill:{color:alt},line:{color:C.border}});
    sl.addShape("rect",{x:nCols.name,y,w:0.14,h:rh,fill:{color:C.blue},line:{color:C.blue}});
    sl.addText(r.name,{x:nCols.name+0.17,y:y+0.06,w:nW.name-0.2,h:0.3,fontSize:8.5,bold:true,color:C.gold,margin:0});
    cell(sl,r.s1,nCols.s1,y,nW.s1,rh,{bg:alt,fc:C.white,fs:8});
    cell(sl,r.s2,nCols.s2,y,nW.s2,rh,{bg:alt,fc:C.white,fs:8});
    cell(sl,r.s3,nCols.s3,y,nW.s3,rh,{bg:alt,fc:C.white,fs:8});
  });
}

// ── WRITE ──────────────────────────────────────────────────────────────────────
const outPath = "/home/daytona/workspace/triads-cheatsheet/Medical_Triads_CheatSheet.pptx";
pres.writeFile({fileName:outPath}).then(()=>{
  console.log("SUCCESS:", outPath);
}).catch(err=>console.error("ERROR:",err));

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/triads-cheatsheet/build.js'