const pptxgen = require("pptxgenjs");

let pres = new pptxgen();
pres.layout = 'LAYOUT_WIDE';
pres.title = 'Snakebite Management Flashcards';
pres.author = 'Orris Medical AI';

// ─── COLOR PALETTE ───────────────────────────────────────────────────────────
const C = {
  darkBg:     "1A1A2E",  // deep navy - title/conclusion
  midBg:      "16213E",  // medium navy
  cardBg:     "0F3460",  // card navy
  accent1:    "E94560",  // red-pink (danger/alert)
  accent2:    "F5A623",  // amber (caution/mnemonic)
  accent3:    "00D4AA",  // teal (action/treatment)
  accent4:    "7B68EE",  // lavender (info)
  white:      "FFFFFF",
  lightGray:  "E8E8F0",
  midGray:    "B0B0C8",
  green:      "27AE60",
  yellow:     "F1C40F",
  red:        "E74C3C",
  orange:     "E67E22",
  lightBg:    "F0F4FF",
  darkText:   "1A1A2E",
  boxGreen:   "1E8449",
  boxYellow:  "B7950B",
  boxRed:     "922B21",
};

// Helper: gradient-like header bar
function addHeader(slide, title, subtitle, bgColor, accentColor) {
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 1.1, fill: { color: bgColor } });
  slide.addShape(pres.ShapeType.rect, { x: 0, y: 1.0, w: 13.3, h: 0.08, fill: { color: accentColor } });
  slide.addText(title, {
    x: 0.3, y: 0.08, w: 9, h: 0.6,
    fontSize: 26, bold: true, color: C.white, fontFace: "Calibri", margin: 0
  });
  if (subtitle) {
    slide.addText(subtitle, {
      x: 0.3, y: 0.62, w: 11, h: 0.38,
      fontSize: 12, color: accentColor, fontFace: "Calibri", margin: 0
    });
  }
}

// Helper: source badge
function addSource(slide, text) {
  slide.addShape(pres.ShapeType.roundRect, {
    x: 10.5, y: 0.18, w: 2.6, h: 0.55,
    fill: { color: "00000030" }, line: { color: C.midGray, width: 0.5 }, rectRadius: 0.08
  });
  slide.addText(text, {
    x: 10.5, y: 0.18, w: 2.6, h: 0.55,
    fontSize: 8.5, color: C.lightGray, align: "center", valign: "middle", fontFace: "Calibri", margin: 0
  });
}

// Helper: rounded card
function addCard(slide, x, y, w, h, fillColor, lineColor) {
  slide.addShape(pres.ShapeType.roundRect, {
    x, y, w, h,
    fill: { color: fillColor },
    line: { color: lineColor || fillColor, width: 1 },
    rectRadius: 0.12
  });
}

// Helper: flowchart box
function addFlowBox(slide, label, x, y, w, h, fillColor, textColor, fontSize) {
  slide.addShape(pres.ShapeType.roundRect, {
    x, y, w, h,
    fill: { color: fillColor },
    line: { color: "00000040", width: 0.8 },
    rectRadius: 0.1
  });
  slide.addText(label, {
    x, y, w, h,
    fontSize: fontSize || 10,
    bold: true,
    color: textColor || C.white,
    align: "center",
    valign: "middle",
    fontFace: "Calibri",
    margin: 0
  });
}

// Helper: arrow
function addArrow(slide, x1, y1, x2, y2) {
  slide.addShape(pres.ShapeType.line, {
    x: x1, y: y1, w: x2 - x1, h: y2 - y1,
    line: { color: C.midGray, width: 1.5, endArrowType: "triangle" }
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 1 — TITLE CARD
// ═══════════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.darkBg } });
  // Snake silhouette accent bar
  s.addShape(pres.ShapeType.rect, { x: 0, y: 6.9, w: 13.3, h: 0.6, fill: { color: C.accent1 } });
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.18, h: 7.5, fill: { color: C.accent1 } });

  s.addText("🐍 SNAKEBITE MANAGEMENT", {
    x: 0.5, y: 1.4, w: 12.3, h: 1.1,
    fontSize: 44, bold: true, color: C.white,
    fontFace: "Calibri", align: "center", charSpacing: 3
  });
  s.addText("CLINICAL FLASHCARD SERIES", {
    x: 0.5, y: 2.55, w: 12.3, h: 0.6,
    fontSize: 22, color: C.accent3, fontFace: "Calibri", align: "center", charSpacing: 8
  });
  s.addShape(pres.ShapeType.rect, { x: 3.5, y: 3.3, w: 6.3, h: 0.05, fill: { color: C.accent2 } });
  s.addText([
    { text: "Flowchart • Mnemonics • Diagrammatic • Evidence-based", options: { breakLine: true } },
  ], {
    x: 0.5, y: 3.5, w: 12.3, h: 0.7,
    fontSize: 14, color: C.midGray, fontFace: "Calibri", align: "center"
  });
  s.addText([
    { text: "Sources: Harrison's Principles of Internal Medicine 22E (2025) • ", options: {} },
    { text: "Tintinalli's Emergency Medicine • ", options: {} },
    { text: "Sabiston Textbook of Surgery", options: {} },
  ], {
    x: 0.5, y: 4.4, w: 12.3, h: 0.5,
    fontSize: 11, color: C.accent2, fontFace: "Calibri", align: "center"
  });

  // topic chips
  const chips = ["Snake ID", "Field Care", "Envenomation Grading", "Antivenom", "Mnemonics", "Disposition"];
  chips.forEach((chip, i) => {
    const cx = 0.9 + i * 2.08;
    s.addShape(pres.ShapeType.roundRect, { x: cx, y: 5.2, w: 1.9, h: 0.45, fill: { color: C.cardBg }, line: { color: C.accent3, width: 1 }, rectRadius: 0.2 });
    s.addText(chip, { x: cx, y: 5.2, w: 1.9, h: 0.45, fontSize: 10, color: C.accent3, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });
  });

  s.addText("7 Flashcards", { x: 0.5, y: 6.3, w: 12.3, h: 0.4, fontSize: 11, color: C.midGray, align: "center", fontFace: "Calibri" });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 2 — SNAKE IDENTIFICATION: VIPER vs ELAPID
// ═══════════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.lightBg } });
  addHeader(s, "FLASHCARD 1 — SNAKE IDENTIFICATION", "Viper vs Elapid: know before you treat", C.darkBg, C.accent2);
  addSource(s, "Harrison's 22E\nTintinalli's EM");

  // Left: Viper panel
  addCard(s, 0.25, 1.3, 5.9, 5.7, "FFF5E6", C.orange);
  s.addShape(pres.ShapeType.rect, { x: 0.25, y: 1.3, w: 5.9, h: 0.55, fill: { color: C.orange } });
  s.addText("🐍 VIPERIDAE (Pit Vipers)", { x: 0.35, y: 1.3, w: 5.7, h: 0.55, fontSize: 14, bold: true, color: C.white, valign: "middle", fontFace: "Calibri", margin: 0 });

  const viperRows = [
    ["Head Shape", "Triangular/arrow-shaped"],
    ["Pupils", "Vertical (elliptical)"],
    ["Fangs", "Long, hollow, foldable"],
    ["Pit organ", "Between eye & nostril (heat sensor)"],
    ["Neck", "Distinct (narrow)"],
    ["Examples", "Rattlesnake, Cobra, Russell's viper, Saw-scaled viper"],
    ["Venom type", "Hemotoxic + Cytotoxic (+ neurotoxic in some)"],
    ["Local effects", "Prominent: swelling, necrosis, pain"],
  ];
  viperRows.forEach(([k, v], i) => {
    const ry = 2.0 + i * 0.54;
    if (i % 2 === 0) s.addShape(pres.ShapeType.rect, { x: 0.3, y: ry, w: 5.8, h: 0.52, fill: { color: "FFF0DC" } });
    s.addText(k + ":", { x: 0.4, y: ry + 0.04, w: 1.5, h: 0.44, fontSize: 9.5, bold: true, color: C.orange, valign: "middle", fontFace: "Calibri", margin: 0 });
    s.addText(v, { x: 1.9, y: ry + 0.04, w: 4.1, h: 0.44, fontSize: 9.5, color: C.darkText, valign: "middle", fontFace: "Calibri", margin: 0 });
  });

  // Right: Elapid panel
  addCard(s, 6.5, 1.3, 6.5, 5.7, "E8F8F5", C.green);
  s.addShape(pres.ShapeType.rect, { x: 6.5, y: 1.3, w: 6.5, h: 0.55, fill: { color: C.green } });
  s.addText("🐍 ELAPIDAE (Cobras, Kraits, Corals)", { x: 6.6, y: 1.3, w: 6.3, h: 0.55, fontSize: 14, bold: true, color: C.white, valign: "middle", fontFace: "Calibri", margin: 0 });

  const elapidRows = [
    ["Head Shape", "Oval/round (non-distinct)"],
    ["Pupils", "Round"],
    ["Fangs", "Short, fixed, erect (front)"],
    ["Pit organ", "Absent"],
    ["Neck", "Non-distinct"],
    ["Examples", "Cobra (Naja), Krait (Bungarus), Mamba, Coral snake"],
    ["Venom type", "Predominantly Neurotoxic"],
    ["Local effects", "Minimal or absent (deceptive!)"],
  ];
  elapidRows.forEach(([k, v], i) => {
    const ry = 2.0 + i * 0.54;
    if (i % 2 === 0) s.addShape(pres.ShapeType.rect, { x: 6.55, y: ry, w: 6.4, h: 0.52, fill: { color: "D5F5EE" } });
    s.addText(k + ":", { x: 6.65, y: ry + 0.04, w: 1.6, h: 0.44, fontSize: 9.5, bold: true, color: C.green, valign: "middle", fontFace: "Calibri", margin: 0 });
    s.addText(v, { x: 8.25, y: ry + 0.04, w: 4.6, h: 0.44, fontSize: 9.5, color: C.darkText, valign: "middle", fontFace: "Calibri", margin: 0 });
  });

  // Mnemonic box at bottom
  addCard(s, 0.25, 6.92, 12.8, 0.45, "1A1A2E", C.accent2);
  s.addText([
    { text: "🔤 MNEMONIC — Coral Snake Rule: ", options: { bold: true, color: C.accent2 } },
    { text: '"Red on Yellow, Kill a Fellow; Red on Black, Venom Lack"', options: { color: C.white, italic: true } },
    { text: " (USA only — NOT valid internationally)", options: { color: C.midGray } },
  ], { x: 0.35, y: 6.93, w: 12.6, h: 0.44, fontSize: 10, valign: "middle", fontFace: "Calibri", margin: 0 });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 3 — FIELD MANAGEMENT FLOWCHART (DO's and DON'Ts + Mnemonic)
// ═══════════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: "F8F0FF" } });
  addHeader(s, "FLASHCARD 2 — FIELD / PREHOSPITAL MANAGEMENT", "First aid that saves lives — and first aid that kills", C.darkBg, C.accent4);
  addSource(s, "Harrison's 22E\nTintinalli's EM");

  // MNEMONIC box
  addCard(s, 0.25, 1.25, 5.6, 2.7, C.darkBg, C.accent4);
  s.addText("🔤 MNEMONIC: \"SICK + RICE\"", { x: 0.4, y: 1.3, w: 5.3, h: 0.45, fontSize: 13, bold: true, color: C.accent4, fontFace: "Calibri", margin: 0 });
  const mnemonicRows = [
    ["S", "Stay calm, don't run"],
    ["I", "Immobilize the limb"],
    ["C", "Clean wound (soap + water)"],
    ["K", "Keep extremity below heart level"],
    ["+", ""],
    ["R", "Remove jewelry & tight clothing"],
    ["I", "IV access (other limb)"],
    ["C", "Call / Contact poison center"],
    ["E", "Emergency transport ASAP"],
  ];
  mnemonicRows.forEach(([letter, desc], i) => {
    if (letter === "+") return;
    const adjusted_i = i > 4 ? i - 1 : i;
    const ry = 1.82 + adjusted_i * 0.27;
    const col = letter === "+" ? C.midGray : (["S","I","C","K"].includes(letter) ? C.accent4 : C.accent3);
    s.addText(letter, { x: 0.4, y: ry, w: 0.3, h: 0.27, fontSize: 12, bold: true, color: col, fontFace: "Calibri", margin: 0, valign: "middle" });
    s.addText("— " + desc, { x: 0.72, y: ry, w: 4.9, h: 0.27, fontSize: 9.5, color: C.lightGray, fontFace: "Calibri", margin: 0, valign: "middle" });
  });

  // DO's column
  addCard(s, 6.1, 1.25, 3.3, 5.8, "E8F8F0", C.green);
  s.addShape(pres.ShapeType.rect, { x: 6.1, y: 1.25, w: 3.3, h: 0.5, fill: { color: C.green } });
  s.addText("✅  DO", { x: 6.2, y: 1.25, w: 3.2, h: 0.5, fontSize: 15, bold: true, color: C.white, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });
  const dos = [
    "Move victim away from snake safely",
    "Immobilize bitten limb (splint)",
    "Remove rings, watches, tight clothing",
    "Clean wound: soap + running water",
    "Maintain limb below heart level",
    "Pressure immobilization bandage for ELAPID bites",
    "Establish IV access (unaffected limb)",
    "Administer O₂ if needed",
    "Transport rapidly to hospital",
    "Note time of bite, snake description",
  ];
  dos.forEach((d, i) => {
    s.addText("• " + d, { x: 6.2, y: 1.85 + i * 0.48, w: 3.1, h: 0.46, fontSize: 9, color: C.darkText, fontFace: "Calibri", margin: 0 });
  });

  // DON'Ts column
  addCard(s, 9.75, 1.25, 3.3, 5.8, "FFF0F0", C.red);
  s.addShape(pres.ShapeType.rect, { x: 9.75, y: 1.25, w: 3.3, h: 0.5, fill: { color: C.red } });
  s.addText("❌  DON'T", { x: 9.85, y: 1.25, w: 3.2, h: 0.5, fontSize: 15, bold: true, color: C.white, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });
  const donts = [
    "Incision & suction of bite site",
    "Apply tourniquet (→ ischemia)",
    "Electric shock treatment",
    "Ice / cold water immersion",
    "Give alcohol",
    "Try to catch or kill the snake",
    "Apply pressure bandage for VIPER bites",
    "Delay transport for 'folk remedies'",
    "Give aspirin / NSAIDs (↑ bleeding)",
    "Cauterize the wound",
  ];
  donts.forEach((d, i) => {
    s.addText("• " + d, { x: 9.85, y: 1.85 + i * 0.48, w: 3.1, h: 0.46, fontSize: 9, color: C.darkText, fontFace: "Calibri", margin: 0 });
  });

  // Bottom note
  s.addShape(pres.ShapeType.rect, { x: 0.25, y: 7.1, w: 12.8, h: 0.28, fill: { color: C.accent1 + "30" } });
  s.addText("⚠  Pressure immobilization bandage: use ONLY for Elapid (neurotoxic) bites. Contraindicated in Viper bites — may worsen local tissue damage.", {
    x: 0.35, y: 7.1, w: 12.6, h: 0.28, fontSize: 9, color: C.red, fontFace: "Calibri", valign: "middle", margin: 0
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 4 — ENVENOMATION SEVERITY GRADING FLOWCHART
// ═══════════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.lightBg } });
  addHeader(s, "FLASHCARD 3 — ENVENOMATION SEVERITY GRADING", "Pit Viper (Crotaline) grading system", C.darkBg, C.accent3);
  addSource(s, "Tintinalli's EM\nHarrison's 22E");

  // Grade boxes
  const grades = [
    { grade: "DRY BITE\n(Grade 0)", color: "27AE60", textCol: C.white, local: "Fang marks only\nNo pain/swelling", systemic: "None", labs: "Normal", antivenom: "None required", note: "Observe 8-12 h" },
    { grade: "MILD\n(Grade I)", color: "F39C12", textCol: C.white, local: "Local pain\nSwelling <30 cm", systemic: "None / minimal\n(nausea)", labs: "Normal or\nmild changes", antivenom: "4 vials FabAV\n(Crotalinae)", note: "Admit, monitor" },
    { grade: "MODERATE\n(Grade II)", color: "E67E22", textCol: C.white, local: "Pain, swelling\n>30 cm", systemic: "Systemic: N/V\ndizziness, mild BP ↓", labs: "Mild coagulopathy\nPlt ↓, PT ↑", antivenom: "4-6 vials FabAV\n(or 10 vials Anavip)", note: "ICU if worsening" },
    { grade: "SEVERE\n(Grade III)", color: "E74C3C", textCol: C.white, local: "Extensive swelling\nNecrosis, bullae", systemic: "Shock, bleeding\nRespiratory failure", labs: "DIC, hemolysis\nRenal failure", antivenom: "≥6 vials FabAV\n(or 10 vials Anavip)", note: "ICU mandatory" },
  ];

  grades.forEach((g, i) => {
    const bx = 0.2 + i * 3.28;
    // Grade header
    s.addShape(pres.ShapeType.roundRect, { x: bx, y: 1.25, w: 3.1, h: 5.9, fill: { color: g.color + "18" }, line: { color: g.color, width: 2 }, rectRadius: 0.15 });
    s.addShape(pres.ShapeType.roundRect, { x: bx, y: 1.25, w: 3.1, h: 0.8, fill: { color: g.color }, line: { color: g.color, width: 2 }, rectRadius: 0.15 });
    s.addText(g.grade, { x: bx + 0.05, y: 1.25, w: 3.0, h: 0.8, fontSize: 13, bold: true, color: g.textCol, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });

    const rows = [
      ["LOCAL", g.local],
      ["SYSTEMIC", g.systemic],
      ["LABS", g.labs],
      ["ANTIVENOM", g.antivenom],
      ["DISPOSITION", g.note],
    ];
    rows.forEach(([label, val], ri) => {
      const ry = 2.2 + ri * 0.95;
      s.addText(label, { x: bx + 0.1, y: ry, w: 2.9, h: 0.28, fontSize: 8.5, bold: true, color: g.color, fontFace: "Calibri", margin: 0 });
      s.addText(val, { x: bx + 0.1, y: ry + 0.28, w: 2.9, h: 0.6, fontSize: 9, color: C.darkText, fontFace: "Calibri", margin: 0 });
    });
  });

  // Note bar
  s.addShape(pres.ShapeType.rect, { x: 0, y: 7.1, w: 13.3, h: 0.4, fill: { color: C.darkBg } });
  s.addText("Grades progress: continuously reassess every 15 min (mark swelling edge on skin, measure circumference at 3 points) — upgrading grade = escalate antivenom.", {
    x: 0.3, y: 7.1, w: 12.7, h: 0.4, fontSize: 9.5, color: C.accent2, fontFace: "Calibri", valign: "middle", margin: 0
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 5 — HOSPITAL MANAGEMENT FLOWCHART
// ═══════════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: "EEF4FF" } });
  addHeader(s, "FLASHCARD 4 — HOSPITAL MANAGEMENT FLOWCHART", "Step-by-step ED algorithm — Harrison's 22E / Tintinalli's EM", C.darkBg, C.accent1);
  addSource(s, "Harrison's 22E\nTintinalli's EM");

  // Flowchart central column
  const steps = [
    { label: "SNAKEBITE VICTIM ARRIVES", color: C.accent1, w: 3.5 },
    { label: "ABC — Airway, Breathing, Circulation\n(intubate early if face/neck bite)", color: "C0392B", w: 3.5 },
    { label: "IV ACCESS × 2 (unaffected limbs)\nMonitor: vitals, ECG, SpO₂, urine output", color: C.cardBg, w: 3.5 },
    { label: "HISTORY + PHYSICAL\nTime of bite • Snake ID • Symptoms\nMark swelling edge on skin", color: "1A5276", w: 3.5 },
    { label: "LABS: CBC, PT/APTT, Fibrinogen, D-dimer\nLFT, RFT, CK, UA, Blood type & cross\n20-min WBCT (if no lab access)", color: "154360", w: 3.5 },
    { label: "GRADE ENVENOMATION\n(Grade 0→III)", color: "4A235A", w: 3.5 },
    { label: "ANTIVENOM if Grade ≥ I\n(see Slide 5 for dosing)", color: C.boxGreen, w: 3.5 },
    { label: "ADMIT: Ward (mild/mod) or ICU (severe)\nObserve ≥6-8 h even if 'dry bite'", color: "1E8449", w: 3.5 },
  ];

  const fcX = 0.25;
  const fcW = 4.2;
  steps.forEach((step, i) => {
    const fy = 1.3 + i * 0.73;
    addFlowBox(s, step.label, fcX, fy, fcW, 0.65, step.color, C.white, 9);
    if (i < steps.length - 1) {
      addArrow(s, fcX + fcW / 2, fy + 0.65, fcX + fcW / 2, fy + 0.73);
    }
  });

  // Right side: Parallel actions panel
  addCard(s, 4.8, 1.25, 4.1, 6.2, "FAFBFF", C.accent4);
  s.addShape(pres.ShapeType.rect, { x: 4.8, y: 1.25, w: 4.1, h: 0.48, fill: { color: C.accent4 } });
  s.addText("PARALLEL ACTIONS", { x: 4.9, y: 1.25, w: 4.0, h: 0.48, fontSize: 13, bold: true, color: C.white, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });

  const parallel = [
    ["Pain control", "Paracetamol / opioids\nAvoid aspirin, NSAIDs (↑ bleeding)"],
    ["Wound care", "Clean, sterile dressing\nDo NOT explore/debride acutely"],
    ["Tetanus", "Update immunization as needed"],
    ["Antibiotics", "Not routinely indicated\nOnly if infection signs present"],
    ["Compartment\nSyndrome?", "Monitor ICP\nFasciotomy rarely needed —\ngive antivenom FIRST"],
    ["Coagulopathy", "Blood products AFTER antivenom\n(antivenom reverses root cause)"],
    ["Serum sickness\n(5-10 days post)", "Prednisone 1 mg/kg/day\n→ taper over 1-2 weeks"],
  ];

  parallel.forEach(([k, v], i) => {
    const ry = 1.85 + i * 0.8;
    if (i % 2 === 0) s.addShape(pres.ShapeType.rect, { x: 4.85, y: ry, w: 4.0, h: 0.78, fill: { color: "EDF2FF" } });
    s.addText(k, { x: 4.9, y: ry + 0.04, w: 1.3, h: 0.7, fontSize: 9, bold: true, color: C.accent4, fontFace: "Calibri", margin: 0 });
    s.addText(v, { x: 6.2, y: ry + 0.04, w: 2.6, h: 0.7, fontSize: 8.5, color: C.darkText, fontFace: "Calibri", margin: 0 });
  });

  // Right side 2: Key lab watch
  addCard(s, 9.2, 1.25, 3.85, 6.2, "FFF8E8", C.accent2);
  s.addShape(pres.ShapeType.rect, { x: 9.2, y: 1.25, w: 3.85, h: 0.48, fill: { color: C.accent2 } });
  s.addText("⚡ KEY DANGER SIGNS", { x: 9.3, y: 1.25, w: 3.7, h: 0.48, fontSize: 13, bold: true, color: C.darkBg, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });

  const dangers = [
    "Rapidly spreading swelling",
    "Ptosis / diplopia (cranial nerve involvement)",
    "Difficulty swallowing / drooling",
    "Respiratory distress",
    "Hypotension / shock",
    "Spontaneous bleeding (gums, IV site)",
    "Dark urine (myoglobinuria/hemoglobinuria)",
    "Oliguria / anuria",
    "Altered sensorium",
    "Incoagulable blood (20-min WBCT)",
    "SpO₂ drop",
  ];
  dangers.forEach((d, i) => {
    s.addShape(pres.ShapeType.rect, { x: 9.25, y: 1.83 + i * 0.5, w: 3.7, h: 0.44, fill: { color: i % 2 === 0 ? "FFF0CC" : "FFFDF0" } });
    s.addText("⚠ " + d, { x: 9.3, y: 1.83 + i * 0.5, w: 3.65, h: 0.44, fontSize: 9, color: "7B3F00", fontFace: "Calibri", margin: 0, valign: "middle" });
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 6 — ANTIVENOM: INDICATIONS, DOSING, REACTIONS
// ═══════════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: "F0FFF8" } });
  addHeader(s, "FLASHCARD 5 — ANTIVENOM: INDICATIONS & DOSING", "The cornerstone of snakebite treatment", C.boxGreen, C.accent3);
  addSource(s, "Harrison's 22E\nTintinalli's EM");

  // Indications box
  addCard(s, 0.2, 1.3, 4.1, 5.8, "E8F8EE", C.green);
  s.addShape(pres.ShapeType.rect, { x: 0.2, y: 1.3, w: 4.1, h: 0.5, fill: { color: C.green } });
  s.addText("INDICATIONS FOR ANTIVENOM", { x: 0.3, y: 1.3, w: 4.0, h: 0.5, fontSize: 12, bold: true, color: C.white, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });

  const indications = [
    ["Any evidence of systemic envenomation:", "hypotension, coagulopathy,\nneurotoxicity, rhabdomyolysis"],
    ["Rapid progressive local swelling:", "crossing a joint within 1 h, or > one limb segment"],
    ["Bite on face, neck, or trunk:", "even without systemic signs"],
    ["20-min WBCT incoagulable:", "(surrogate for severe coagulopathy)"],
    ["Grade I–III envenomation:", "(see grading slide)"],
  ];
  let iy = 1.9;
  indications.forEach(([k, v]) => {
    s.addText("• " + k, { x: 0.3, y: iy, w: 3.9, h: 0.28, fontSize: 9.5, bold: true, color: C.darkText, fontFace: "Calibri", margin: 0 });
    s.addText("  " + v, { x: 0.3, y: iy + 0.27, w: 3.9, h: 0.38, fontSize: 9, color: "2C5F2E", fontFace: "Calibri", margin: 0 });
    iy += 0.72;
  });

  s.addShape(pres.ShapeType.rect, { x: 0.25, y: 5.6, w: 4.0, h: 0.06, fill: { color: C.red } });
  s.addText("⚠ No absolute contraindication!\n(Even allergy is a relative CI — premedicate + give)", {
    x: 0.25, y: 5.7, w: 4.0, h: 0.5, fontSize: 9, color: C.red, bold: true, fontFace: "Calibri", margin: 0
  });

  // Dosing table
  addCard(s, 4.55, 1.3, 5.0, 5.8, "FAFEFF", C.accent3);
  s.addShape(pres.ShapeType.rect, { x: 4.55, y: 1.3, w: 5.0, h: 0.5, fill: { color: C.accent3 } });
  s.addText("DOSING GUIDE (Crotalinae — USA)", { x: 4.65, y: 1.3, w: 4.9, h: 0.5, fontSize: 12, bold: true, color: C.darkBg, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });

  const dosing = [
    ["Product", "FabAV\n(Crofab®)", "F(ab')₂\n(Anavip®)"],
    ["Mild", "4 vials", "10 vials"],
    ["Moderate", "4–6 vials", "10 vials"],
    ["Severe", "≥6 vials", "10 vials"],
    ["Maintenance", "2 vials q6h × 3", "4 vials for\nrecurrent coagulopathy"],
    ["Diluent", "250 mL NS", "250 mL NS"],
    ["Infusion", "IV over 1 h\nStart 25-50 mL/h × 10 min\nThen 250 mL/h", "IV over 1 h"],
    ["Repeat", "If progressing,\nrepeat initial dose", "Same"],
  ];

  dosing.forEach(([col1, col2, col3], i) => {
    const dy = 1.92 + i * 0.62;
    const bg = i === 0 ? C.accent3 + "40" : (i % 2 === 0 ? "E8FFFC" : "FAFFFE");
    s.addShape(pres.ShapeType.rect, { x: 4.6, y: dy, w: 4.9, h: 0.6, fill: { color: bg } });
    [col1, col2, col3].forEach((txt, ci) => {
      const cx = 4.65 + ci * 1.62;
      s.addText(txt, {
        x: cx, y: dy + 0.03, w: 1.55, h: 0.55,
        fontSize: i === 0 ? 9.5 : 9, bold: i === 0, color: C.darkText, fontFace: "Calibri",
        align: "center", valign: "middle", margin: 0
      });
    });
  });

  // Reaction management
  addCard(s, 9.8, 1.3, 3.25, 5.8, "FFF5F5", C.red);
  s.addShape(pres.ShapeType.rect, { x: 9.8, y: 1.3, w: 3.25, h: 0.5, fill: { color: C.red } });
  s.addText("ANAPHYLAXIS TO\nANTIVENOM", { x: 9.9, y: 1.3, w: 3.1, h: 0.5, fontSize: 11, bold: true, color: C.white, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });

  const rxnSteps = [
    "1. STOP infusion immediately",
    "2. Epinephrine IM (or IV if severe\n   hypotension)",
    "3. Antihistamines IV",
    "4. Glucocorticoids IV",
    "5. When reaction controlled → RESTART\n   antivenom at 5-10 mL/h; titrate up",
    "6. Continue until patient stabilizes",
    "",
    "SERUM SICKNESS (5-10 days):",
    "Fever • Rash • Arthralgias",
    "→ Prednisone 1 mg/kg/day × 1-2 wk",
  ];
  rxnSteps.forEach((step, i) => {
    s.addText(step, {
      x: 9.9, y: 1.9 + i * 0.46, w: 3.1, h: 0.44,
      fontSize: 9, color: step.startsWith("SERUM") ? C.red : C.darkText,
      bold: step.startsWith("SERUM"),
      fontFace: "Calibri", margin: 0
    });
  });

  s.addShape(pres.ShapeType.rect, { x: 0, y: 7.05, w: 13.3, h: 0.45, fill: { color: C.darkBg } });
  s.addText("🔑 Key principle: Antivenom dose is based on SEVERITY OF ENVENOMATION, NOT patient weight. Children get the same dose as adults.", {
    x: 0.3, y: 7.05, w: 12.7, h: 0.45, fontSize: 10, color: C.accent2, fontFace: "Calibri", valign: "middle", margin: 0
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 7 — VENOM EFFECTS & MECHANISM DIAGRAM
// ═══════════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: "FFF8EE" } });
  addHeader(s, "FLASHCARD 6 — VENOM EFFECTS & PATHOPHYSIOLOGY", "Diagrammatic overview of toxin mechanisms", C.darkBg, C.accent2);
  addSource(s, "Harrison's 22E\nSabiston Surgery");

  // Central venom node
  s.addShape(pres.ShapeType.ellipse, { x: 5.3, y: 2.8, w: 2.7, h: 1.1, fill: { color: C.accent1 }, line: { color: C.red, width: 2 } });
  s.addText("SNAKE\nVENOM", { x: 5.3, y: 2.8, w: 2.7, h: 1.1, fontSize: 14, bold: true, color: C.white, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });

  // Effects radiating out - manual lines + boxes
  // LEFT branches (Viper-dominant effects)
  const lEffects = [
    { label: "CYTOTOXINS\nPhospholipases A₂\nHyaluronidase", y: 1.4, color: "922B21" },
    { label: "HEMOTOXINS\nThrombin-like enzymes\nFibrinolysins → DIC", y: 2.5, color: "78281F" },
    { label: "MYOTOXINS\nCK↑, Rhabdomyolysis\nMyoglobinuria", y: 3.6, color: "A04000" },
    { label: "CARDIOTOXINS\nHypotension\nDysrhythmia", y: 4.7, color: "6E2F2F" },
  ];
  lEffects.forEach(ef => {
    addCard(s, 0.2, ef.y, 3.0, 0.85, ef.color + "22", ef.color);
    s.addText(ef.label, { x: 0.3, y: ef.y + 0.04, w: 2.8, h: 0.78, fontSize: 9, color: C.darkText, fontFace: "Calibri", margin: 0, valign: "middle" });
    // arrow to center
    s.addShape(pres.ShapeType.line, { x: 3.2, y: ef.y + 0.42, w: 2.1, h: 3.35 - ef.y - 0.42 + (ef.y < 3.35 ? 0 : 0), line: { color: ef.color, width: 1, endArrowType: "triangle" } });
  });
  // Actually let me fix the arrows to just go toward center
  // Clear complex math - do simple approach
  lEffects.forEach(ef => {
    const fromX = 3.22; const fromY = ef.y + 0.42;
    const toX = 5.28; const toY = 3.35;
    s.addShape(pres.ShapeType.line, { x: fromX, y: fromY, w: toX - fromX, h: toY - fromY, line: { color: ef.color, width: 1.2, endArrowType: "triangle" } });
  });

  // RIGHT branches (Elapid-dominant effects)
  const rEffects = [
    { label: "NEUROTOXINS\nPostsynaptic (α): Cobra\nPresynaptic (β): Krait/Mamba", y: 1.4, color: "1A5276" },
    { label: "CHOLINESTERASE\nINHIBITION\nPtosis, diplopia, dysphagia", y: 2.5, color: "154360" },
    { label: "COAGULOTOXINS\nSaw-scaled viper\nVascular damage", y: 3.6, color: "0E6655" },
    { label: "NEPHROTOXINS\nRussell's viper\nDirect tubular damage, AKI", y: 4.7, color: "145A32" },
  ];
  rEffects.forEach(ef => {
    addCard(s, 10.1, ef.y, 3.0, 0.85, ef.color + "22", ef.color);
    s.addText(ef.label, { x: 10.2, y: ef.y + 0.04, w: 2.8, h: 0.78, fontSize: 9, color: C.darkText, fontFace: "Calibri", margin: 0, valign: "middle" });
    const fromX = 8.02; const fromY = 3.35;
    const toX = 10.08; const toY = ef.y + 0.42;
    s.addShape(pres.ShapeType.line, { x: fromX, y: fromY, w: toX - fromX, h: toY - fromY, line: { color: ef.color, width: 1.2, endArrowType: "triangle" } });
  });

  // Labels
  s.addText("VIPER-DOMINANT", { x: 0.2, y: 5.7, w: 3.0, h: 0.35, fontSize: 10, bold: true, color: C.red, align: "center", fontFace: "Calibri", margin: 0 });
  s.addText("ELAPID-DOMINANT", { x: 10.1, y: 5.7, w: 3.0, h: 0.35, fontSize: 10, bold: true, color: "1A5276", align: "center", fontFace: "Calibri", margin: 0 });
  s.addText("(Both can overlap)", { x: 4.5, y: 5.7, w: 4.3, h: 0.3, fontSize: 10, color: C.midGray, align: "center", fontFace: "Calibri", margin: 0 });

  // Bottom: AVIPS mnemonic
  addCard(s, 0.2, 6.15, 12.9, 1.1, C.darkBg, C.accent2);
  s.addText("🔤 MNEMONIC — 'AVIPS' = Venom Effects to Remember:", {
    x: 0.4, y: 6.18, w: 5.5, h: 0.4, fontSize: 11, bold: true, color: C.accent2, fontFace: "Calibri", margin: 0
  });
  const avips = [
    ["A", "Autopharmacological (histamine, bradykinin release)"],
    ["V", "Vascular damage (capillary leak → edema)"],
    ["I", "Immuno-complex formation"],
    ["P", "Paralysis (neurotoxins → NMJ block)"],
    ["S", "Sanguinolytic (coagulopathy, DIC)"],
  ];
  avips.forEach(([letter, desc], i) => {
    const ax = 0.4 + i * 2.5;
    s.addText(letter + " - " + desc, { x: ax, y: 6.62, w: 2.45, h: 0.55, fontSize: 8.5, color: C.lightGray, fontFace: "Calibri", margin: 0 });
  });
}

// ═══════════════════════════════════════════════════════════════════════════════
// SLIDE 8 — MASTER MNEMONIC + DISPOSITION CARD
// ═══════════════════════════════════════════════════════════════════════════════
{
  let s = pres.addSlide();
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.darkBg } });
  addHeader(s, "FLASHCARD 7 — MASTER MNEMONICS & DISPOSITION", "Summary for rapid recall in the ED", C.midBg, C.accent3);
  addSource(s, "Harrison's 22E\nTintinalli's EM");

  // Left: Big mnemonic SNAKE
  addCard(s, 0.2, 1.3, 5.5, 5.5, "1A2744", C.accent3);
  s.addText("🔤 MNEMONIC: \"SNAKE\" — Management Steps", {
    x: 0.35, y: 1.35, w: 5.2, h: 0.45, fontSize: 12, bold: true, color: C.accent3, fontFace: "Calibri", margin: 0
  });

  const snakeMnemonic = [
    { L: "S", title: "Stabilize ABCs", body: "Airway, Breathing, Circulation first\nEarly intubation if face/neck bite" },
    { L: "N", title: "Neutralize venom", body: "Antivenom is the ONLY definitive Rx\nDose based on envenomation severity\nGive BEFORE blood products" },
    { L: "A", title: "Assess & monitor", body: "Mark swelling edge on skin Q15 min\nMeasure limb circumference × 3 points\nLabs: CBC, coag, RFT, LFT, CK, UA" },
    { L: "K", title: "Keep watching", body: "Observe minimum 6-8 h\n(Dry bite) or 24-48 h (envenomation)\nWatch for recurrent coagulopathy" },
    { L: "E", title: "Extras: wound + serum sickness", body: "Tetanus immunization\nWound care (no early debridement)\nPrevent/treat serum sickness" },
  ];

  snakeMnemonic.forEach((item, i) => {
    const ry = 1.9 + i * 0.95;
    s.addShape(pres.ShapeType.roundRect, { x: 0.3, y: ry, w: 0.55, h: 0.85, fill: { color: C.accent3 }, rectRadius: 0.08 });
    s.addText(item.L, { x: 0.3, y: ry, w: 0.55, h: 0.85, fontSize: 22, bold: true, color: C.darkBg, align: "center", valign: "middle", fontFace: "Calibri", margin: 0 });
    s.addText(item.title, { x: 0.95, y: ry + 0.04, w: 4.65, h: 0.32, fontSize: 10.5, bold: true, color: C.accent3, fontFace: "Calibri", margin: 0 });
    s.addText(item.body, { x: 0.95, y: ry + 0.35, w: 4.65, h: 0.52, fontSize: 8.5, color: C.lightGray, fontFace: "Calibri", margin: 0 });
  });

  // Middle: Disposition algorithm
  addCard(s, 6.0, 1.3, 3.5, 5.5, "1C2B4A", C.accent4);
  s.addText("DISPOSITION ALGORITHM", { x: 6.1, y: 1.35, w: 3.3, h: 0.45, fontSize: 12, bold: true, color: C.accent4, fontFace: "Calibri", margin: 0 });

  const dispBoxes = [
    { label: "DRY BITE (Grade 0)\nNo envenomation signs\nNormal labs", action: "Observe 8-12 h\n→ DISCHARGE with\n   return precautions", color: C.green },
    { label: "MILD (Grade I)\nLocal effects only\nStable labs", action: "Admit to general ward\nAntivenom + monitoring\nPhysical therapy", color: C.yellow },
    { label: "MODERATE (Grade II)\nSystemic ± coagulopathy", action: "Admit to ward/HDU\nAntivenom ± repeat\nSerial labs Q6h", color: C.orange },
    { label: "SEVERE (Grade III)\nShock, DIC, resp failure", action: "ICU ADMISSION\nICU monitoring\nMay need vasopressors", color: C.red },
  ];

  dispBoxes.forEach((box, i) => {
    const dy = 1.92 + i * 1.2;
    addCard(s, 6.1, dy, 1.5, 1.1, box.color + "33", box.color);
    s.addText(box.label, { x: 6.15, y: dy + 0.04, w: 1.4, h: 1.02, fontSize: 7.5, color: C.lightGray, fontFace: "Calibri", margin: 0 });
    addCard(s, 7.7, dy, 1.7, 1.1, box.color + "22", box.color);
    s.addText("→ " + box.action, { x: 7.75, y: dy + 0.04, w: 1.6, h: 1.02, fontSize: 8, color: C.lightGray, fontFace: "Calibri", margin: 0 });
  });

  // Right: Quick recall facts
  addCard(s, 9.75, 1.3, 3.35, 5.5, "1C2B4A", C.accent2);
  s.addText("⚡ RAPID RECALL FACTS", { x: 9.85, y: 1.35, w: 3.15, h: 0.45, fontSize: 12, bold: true, color: C.accent2, fontFace: "Calibri", margin: 0 });

  const facts = [
    ["Antivenom dose", "Same in children & adults\n(based on envenomation severity)"],
    ["Start infusion", "25-50 mL/h × 10 min, then 250 mL/h"],
    ["Blood products", "Give AFTER antivenom, not before"],
    ["Prophylactic Abx", "NOT routinely needed"],
    ["Steroids", "NOT for envenomation itself\n(only for allergic reactions)"],
    ["Ice / tourniquet", "NEVER — worsen outcome"],
    ["Incision/suction", "NEVER — proven ineffective"],
    ["Pressure bandage", "Elapid bites ONLY"],
    ["Serum sickness", "5-10 days: fever, rash, arthralgia\nPrednisone 1 mg/kg × 2 weeks"],
    ["Recurrent coagulopathy", "Can occur 2-3 wk after Fx(ab') AVIP\nRepeat testing at discharge"],
  ];

  facts.forEach(([k, v], i) => {
    const fy = 1.92 + i * 0.48;
    const bg = i % 2 === 0 ? "1E3A5F" : "1C2B4A";
    s.addShape(pres.ShapeType.rect, { x: 9.8, y: fy, w: 3.25, h: 0.46, fill: { color: bg } });
    s.addText(k + ":", { x: 9.85, y: fy + 0.02, w: 1.1, h: 0.42, fontSize: 8, bold: true, color: C.accent2, fontFace: "Calibri", margin: 0, valign: "middle" });
    s.addText(v, { x: 10.95, y: fy + 0.02, w: 2.05, h: 0.42, fontSize: 7.5, color: C.lightGray, fontFace: "Calibri", margin: 0, valign: "middle" });
  });

  // Footer
  s.addShape(pres.ShapeType.rect, { x: 0, y: 7.05, w: 13.3, h: 0.45, fill: { color: C.accent1 } });
  s.addText("SOURCE: Harrison's Principles of Internal Medicine 22E (2025) • Tintinalli's Emergency Medicine (9E) • Sabiston Textbook of Surgery — Orris Medical AI, June 2026", {
    x: 0.3, y: 7.05, w: 12.7, h: 0.45, fontSize: 9, color: C.white, fontFace: "Calibri", align: "center", valign: "middle", margin: 0
  });
}

// ─── WRITE FILE ───────────────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/snakebite/Snakebite_Management_Flashcards.pptx" })
  .then(() => console.log("✅ Saved: /home/daytona/workspace/snakebite/Snakebite_Management_Flashcards.pptx"))
  .catch(err => { console.error("❌ Error:", err); process.exit(1); });