from reportlab.lib import colors
from reportlab.lib.enums import TA_CENTER
from reportlab.lib.pagesizes import A4
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.units import cm
from reportlab.platypus import (SimpleDocTemplate, Paragraph, Spacer, PageBreak, Table, TableStyle, KeepTogether)
from reportlab.pdfbase.pdfmetrics import stringWidth
from reportlab.graphics.shapes import Drawing, String, Line, Circle
from reportlab.graphics import renderPDF
from reportlab.pdfbase.ttfonts import TTFont
from reportlab.pdfbase import pdfmetrics
from reportlab.lib.colors import HexColor
from pathlib import Path

OUT = Path('/tmp/workspace/applied-basic-sciences-solved/output/Applied_Basic_Sciences_Solved_Answers.pdf')

styles = getSampleStyleSheet()
styles.add(ParagraphStyle(name='TitleCustom', parent=styles['Title'], fontName='Helvetica-Bold', fontSize=17, leading=21, alignment=TA_CENTER, textColor=HexColor('#152c4a'), spaceAfter=8))
styles.add(ParagraphStyle(name='SubTitle', parent=styles['Normal'], fontSize=9.5, leading=13, alignment=TA_CENTER, textColor=HexColor('#44546a'), spaceAfter=14))
styles.add(ParagraphStyle(name='Q', parent=styles['Heading2'], fontName='Helvetica-Bold', fontSize=12, leading=15, textColor=HexColor('#17365d'), spaceBefore=10, spaceAfter=5, keepWithNext=True))
styles.add(ParagraphStyle(name='Body2', parent=styles['BodyText'], fontName='Helvetica', fontSize=9.3, leading=12.2, spaceAfter=4))
styles.add(ParagraphStyle(name='Small', parent=styles['BodyText'], fontSize=8.2, leading=10.2, textColor=HexColor('#444444')))
styles.add(ParagraphStyle(name='DiagramLabel', parent=styles['BodyText'], fontSize=8.0, leading=9.5, alignment=TA_CENTER, textColor=HexColor('#444444')))

B = styles['Body2']; Q=styles['Q']; S=styles['Small']
def P(text, style=B): return Paragraph(text, style)
def bullets(items):
    return [P('• ' + x) for x in items]

def header_footer(canvas, doc):
    canvas.saveState()
    canvas.setStrokeColor(HexColor('#9fbad0')); canvas.setLineWidth(.45)
    canvas.line(doc.leftMargin, A4[1]-1.15*cm, A4[0]-doc.rightMargin, A4[1]-1.15*cm)
    canvas.setFont('Helvetica', 8); canvas.setFillColor(HexColor('#58708a'))
    canvas.drawString(doc.leftMargin, A4[1]-.85*cm, 'B.Sc. Medical Technology (OT), 1st Year | Applied Basic Sciences')
    canvas.drawRightString(A4[0]-doc.rightMargin, .75*cm, f'Page {doc.page}')
    canvas.restoreState()

def coronary_diagram():
    d=Drawing(470,205)
    blue=HexColor('#1d4f7a'); red=HexColor('#b43336'); grey=HexColor('#555555')
    # stylised heart
    d.add(Circle(235,96,57,strokeColor=blue,fillColor=colors.white,strokeWidth=1.3))
    d.add(String(218,96,'HEART',fontSize=11,fillColor=grey))
    # aorta
    d.add(Line(235,153,235,188,strokeColor=red,strokeWidth=4)); d.add(String(244,183,'Ascending aorta',fontSize=8,fillColor=grey))
    # left coronary stem & branches
    d.add(Line(230,167,181,145,strokeColor=red,strokeWidth=3)); d.add(String(107,146,'Left coronary artery (LCA)',fontSize=8,fillColor=grey))
    d.add(Line(181,145,154,96,strokeColor=red,strokeWidth=2.8)); d.add(String(72,91,'LAD / anterior interventricular',fontSize=8,fillColor=grey))
    d.add(Line(181,145,127,157,strokeColor=red,strokeWidth=2.8)); d.add(String(28,160,'Circumflex (LCx)',fontSize=8,fillColor=grey))
    d.add(Line(153,96,133,62,strokeColor=red,strokeWidth=1.8)); d.add(String(45,49,'Diagonal branches',fontSize=8,fillColor=grey))
    d.add(Line(127,157,98,137,strokeColor=red,strokeWidth=1.8)); d.add(String(18,124,'Obtuse marginal branches',fontSize=8,fillColor=grey))
    # right coronary
    d.add(Line(240,167,293,145,strokeColor=red,strokeWidth=3)); d.add(String(299,146,'Right coronary artery (RCA)',fontSize=8,fillColor=grey))
    d.add(Line(293,145,320,103,strokeColor=red,strokeWidth=2.8)); d.add(String(324,98,'Right marginal',fontSize=8,fillColor=grey))
    d.add(Line(320,103,330,62,strokeColor=red,strokeWidth=2.8)); d.add(String(335,56,'PDA / posterior interventricular',fontSize=8,fillColor=grey))
    d.add(String(8,11,'Usual right-dominant pattern: PDA arises from RCA. Coronary arteries fill mainly in diastole.',fontSize=8,fillColor=grey))
    return d

def willis_diagram():
    d=Drawing(470,225); c=HexColor('#a42f35'); g=HexColor('#454545')
    # Anterior top
    d.add(Line(190,186,280,186,strokeColor=c,strokeWidth=4)); d.add(String(195,196,'Anterior communicating artery',fontSize=8,fillColor=g))
    d.add(Line(190,186,165,142,strokeColor=c,strokeWidth=4)); d.add(Line(280,186,305,142,strokeColor=c,strokeWidth=4))
    d.add(String(122,136,'L ACA',fontSize=8,fillColor=g)); d.add(String(309,136,'R ACA',fontSize=8,fillColor=g))
    # internal carotids and MCA
    d.add(Line(165,142,165,98,strokeColor=c,strokeWidth=4)); d.add(Line(305,142,305,98,strokeColor=c,strokeWidth=4))
    d.add(String(124,93,'L ICA',fontSize=8,fillColor=g)); d.add(String(309,93,'R ICA',fontSize=8,fillColor=g))
    d.add(Line(165,120,92,120,strokeColor=c,strokeWidth=4)); d.add(Line(305,120,378,120,strokeColor=c,strokeWidth=4))
    d.add(String(41,114,'L MCA',fontSize=8,fillColor=g)); d.add(String(385,114,'R MCA',fontSize=8,fillColor=g))
    # posterior connections / basilar
    d.add(Line(165,98,207,59,strokeColor=c,strokeWidth=4)); d.add(Line(305,98,263,59,strokeColor=c,strokeWidth=4))
    d.add(String(100,62,'L posterior communicating',fontSize=8,fillColor=g)); d.add(String(283,62,'R posterior communicating',fontSize=8,fillColor=g))
    d.add(Line(207,59,263,59,strokeColor=c,strokeWidth=4)); d.add(String(211,44,'Posterior cerebral arteries (PCA)',fontSize=8,fillColor=g))
    d.add(Line(235,8,235,59,strokeColor=c,strokeWidth=5)); d.add(String(244,19,'Basilar artery',fontSize=8,fillColor=g))
    d.add(String(6,211,'Circle of Willis: arterial anastomotic ring at the brain base. MCAs are branches of ICA but not part of the ring.',fontSize=8,fillColor=g))
    return d

def section(num, question, content, diagram=None):
    story.append(P(f'Q.{num}. {question}', Q))
    story.extend(content)
    if diagram:
        story.append(Spacer(1,3)); story.append(diagram); story.append(Spacer(1,4))

story=[]
story.append(Spacer(1, .35*cm))
story.append(P('SOLVED QUESTION PAPER', styles['TitleCustom']))
story.append(P('B.Sc. Medical Technology (OT), 1st Year - Annual 2018<br/>Applied Basic Sciences | Each answer framed for 5 marks', styles['SubTitle']))
intro = Table([[P('<b>How to use this file:</b> The answers are concise, exam-oriented model answers. Diagrams are schematic and should be redrawn larger in the examination. Drug doses and resuscitation algorithms are stated for study purposes; apply current institutional protocols in clinical practice.',S)]], colWidths=[16.7*cm])
intro.setStyle(TableStyle([('BACKGROUND',(0,0),(-1,-1),HexColor('#eef4f9')),('BOX',(0,0),(-1,-1),.4,HexColor('#b7cada')),('LEFTPADDING',(0,0),(-1,-1),8),('RIGHTPADDING',(0,0),(-1,-1),8),('TOPPADDING',(0,0),(-1,-1),6),('BOTTOMPADDING',(0,0),(-1,-1),6)]))
story += [intro, Spacer(1,8)]

section(1,'What is PIN INDEX System and its use?',[
P('<b>Pin Index Safety System (PISS)</b> is a mechanical safety system used on small compressed-gas cylinders (usually E-cylinders) attached to an anaesthesia machine hanger yoke.'),
P('<b>Principle:</b> Each medical gas has a unique arrangement of two holes on the cylinder valve face. Matching pins on the yoke fit only that pattern. The Bodok seal forms the gas-tight seal.'),
P('<b>Use:</b> It prevents attachment of a wrong gas cylinder to a yoke, thus reducing delivery of a wrong gas such as nitrous oxide instead of oxygen.'),
P('<b>Examples of pin positions:</b> oxygen 2,5; nitrous oxide 3,5; air 1,5; carbon dioxide 1,6.'),
P('<b>Limitations:</b> It is not foolproof if pins are damaged, removed or deliberately bypassed; it does not identify a wrongly filled or wrongly labelled cylinder. Cylinder label, colour code and pressure must still be checked.')])

section(2,'Mallampati Grading',[
P('<b>Purpose:</b> A bedside airway assessment which relates tongue size to the visible pharyngeal structures and helps predict difficulty in direct laryngoscopy/intubation. Examine the seated patient with mouth maximally open and tongue protruded, without phonation.'),
P('<b>Modified Mallampati classes:</b>'),
*bullets(['<b>Class I:</b> soft palate, fauces, uvula and tonsillar pillars visible.', '<b>Class II:</b> soft palate, fauces and uvula visible; pillars are not visible.', '<b>Class III:</b> soft palate and base of uvula visible.', '<b>Class IV:</b> only hard palate visible.']),
P('Classes III and IV suggest a potentially difficult laryngoscopy. It must be combined with mouth opening, thyromental distance, neck movement, dentition and history; it is not sufficient alone.')])

section(3,'Enumerate parts of a fibreoptic bronchoscope.',[
P('A flexible fibreoptic bronchoscope has the following main parts:'),
*bullets(['<b>Control section/handle:</b> eyepiece or camera connector; angulation control lever(s); suction-valve port; working-channel inlet; and light-guide connector.', '<b>Insertion tube:</b> flexible shaft with an outer sheath, image fibre bundle, light-transmitting fibres and working/suction channel.', '<b>Distal bending section and tip:</b> articulates up/down and contains the objective lens, illumination windows and working-channel outlet.', '<b>Universal cord:</b> carries the light guide to the light source and connects to camera/video processor.', '<b>Accessories:</b> suction tubing, biopsy forceps, cytology brush, lavage catheter and a bite block.']),
P('Video bronchoscopes have a miniature electronic camera chip at the distal tip instead of an image fibre bundle, but the functional components are similar.')])

section(4,'Classify hypothermia and list its complications.',[
P('<b>Definition:</b> core temperature below 35°C.'),
P('<b>Classification by core temperature:</b> mild 32-35°C; moderate 28-32°C; severe below 28°C (some texts call below 20°C profound).'),
P('<b>Complications:</b>'),
*bullets(['<b>Cardiovascular:</b> bradycardia, reduced cardiac output, hypotension, atrial/ventricular arrhythmias and cardiac arrest.', '<b>Respiratory/metabolic:</b> reduced ventilatory drive, acidosis, hypoxaemia and reduced drug metabolism with delayed recovery.', '<b>Coagulation:</b> platelet dysfunction and impaired enzyme activity causing bleeding/coagulopathy.', '<b>Neuromuscular:</b> shivering, increased oxygen consumption, impaired consciousness and prolonged neuromuscular blockade.', '<b>Renal and infection:</b> cold diuresis, electrolyte disturbance, impaired wound healing and increased surgical-site infection risk.'])])

section(5,'Enumerate components of balanced anaesthesia. Describe complications of Propofol.',[
P('<b>Balanced anaesthesia</b> uses several agents/techniques so that hypnosis, analgesia, muscle relaxation and autonomic stability are achieved with lower doses and fewer adverse effects from any one agent.'),
P('<b>Components:</b> premedication (anxiolysis, antisialagogue, aspiration prophylaxis); induction/hypnosis (e.g., propofol); analgesia (opioid and/or regional block); muscle relaxation; maintenance with volatile agent or TIVA plus oxygen/air; controlled ventilation and monitoring; reversal, analgesia and antiemetic care.'),
P('<b>Propofol adverse effects/complications:</b>'),
*bullets(['Pain on injection, especially in small veins.', 'Dose-related hypotension from vasodilation and myocardial depression; bradycardia, rarely severe bradycardia/asystole.', 'Apnoea and respiratory depression after induction.', 'Myoclonus or excitatory movements are uncommon; loss of airway reflexes can cause obstruction/aspiration.', 'Hypertriglyceridaemia and infection risk from mishandling of the lipid emulsion.', '<b>Propofol infusion syndrome</b> with prolonged high-dose infusion: metabolic acidosis, rhabdomyolysis, hyperkalaemia, renal failure, arrhythmia and cardiac failure. It can be fatal.', 'Rare anaphylaxis.'])])

section(6,'Short note on sitting position in posterior fossa tumour.',[
P('<b>Description:</b> After anaesthesia, the patient is gradually raised to a semi-sitting position. The head is fixed in pins, flexed only enough to allow surgical access, and kept above the level of the right atrium. It gives excellent exposure of the posterior fossa and upper cervical region.'),
P('<b>Advantages:</b> gravity improves venous and CSF drainage, reduces venous bleeding and cerebellar retraction, and provides good operative access.'),
P('<b>Precautions:</b> secure airway and all lines; gradual positioning; head and neck must not be over-flexed (maintain at least 2-3 finger breadths from chin to sternum); pad pressure points; avoid excessive hip/knee flexion; apply compression devices; level/zero arterial transducer at the external auditory meatus; monitor for venous air embolism (VAE), ideally with precordial Doppler or transoesophageal echo.'),
P('<b>Complications:</b> VAE and paradoxical embolism (especially patent foramen ovale), hypotension and reduced cerebral perfusion, tension pneumocephalus, quadriplegia/neuropraxia from neck malposition, macroglossia/airway oedema, pressure injury and DVT. A preoperative screen for intracardiac right-to-left shunt is important when using this position.')])

section(7,'Draw a labelled diagram of blood supply of heart.',[
P('The heart receives arterial blood from the right and left coronary arteries, which arise from the corresponding aortic sinuses. The schematic below shows the principal branches.'), coronary_diagram(),
P('<b>Territories:</b> LCA generally supplies left atrium, most of left ventricle, and anterior two-thirds of interventricular septum through LAD/LCx. RCA generally supplies right atrium, most of right ventricle, inferior LV and posterior one-third of septum in right dominance. SA nodal and AV nodal branches commonly arise from RCA.')])

section(8,'Describe systemic toxicity in local anaesthesia.',[
P('<b>Local anaesthetic systemic toxicity (LAST)</b> occurs when plasma local anaesthetic concentration becomes excessive, usually after inadvertent intravascular injection, overdose, rapid absorption from a vascular site, or impaired clearance.'),
P('<b>Early CNS features:</b> circumoral numbness, metallic taste, tinnitus, dizziness, blurred vision, agitation, dysarthria and tremor. <b>Progression:</b> seizures, CNS depression, coma and respiratory arrest.'),
P('<b>Cardiovascular features:</b> hypertension/tachycardia may occur initially, followed by myocardial depression, hypotension, conduction delay, bradycardia, wide-complex arrhythmia, ventricular fibrillation and cardiac arrest. Bupivacaine is particularly cardiotoxic.'),
P('<b>Prevention:</b> calculate dose by lean body weight where appropriate, inject incrementally, aspirate before injection, use ultrasound where relevant, add epinephrine test dose when appropriate, and use monitoring with immediate resuscitation capability.'),
P('<b>Management:</b> stop injection; call for help; maintain airway and give 100% oxygen, treat seizures with benzodiazepine, begin CPR if needed, and give 20% lipid emulsion according to the current LAST protocol. Avoid large doses of propofol in cardiovascular collapse and avoid vasopressin, calcium-channel blockers and beta-blockers. Continue observation because recurrence can occur.')])

section(9,'Describe Circle of Willis with diagram.',[
P('<b>Circle of Willis</b> is an arterial anastomotic polygon on the base of the brain, around the optic chiasm and infundibulum. It links the internal carotid circulation to the vertebrobasilar circulation and provides potential collateral flow.'), willis_diagram(),
P('<b>Components:</b> anterior communicating artery; right and left anterior cerebral arteries (A1 segments); terminal portions of right and left internal carotid arteries; right and left posterior communicating arteries; and right and left posterior cerebral arteries (P1 segments).'),
P('<b>Clinical importance:</b> aneurysms commonly occur at branch points, particularly the anterior communicating artery and posterior communicating artery. Anatomical variants are common, and collateral flow may be incomplete.')])

section(10,'Difficult airway cart - describe.',[
P('<b>Purpose:</b> A clearly labelled, immediately available trolley containing equipment and a written algorithm for predicted or unanticipated difficult ventilation, intubation and emergency front-of-neck access.'),
P('<b>Suggested contents:</b>'),
*bullets(['<b>Oxygenation/ventilation:</b> oxygen source, masks of all sizes, oral/nasal airways, two-person bag-mask equipment, suction and capnography.', '<b>Intubation:</b> laryngoscope handles and blades including video laryngoscope, endotracheal tubes of different sizes, stylets, bougies, introducers, tube exchangers and Magill forceps.', '<b>Supraglottic rescue:</b> second-generation supraglottic airway devices in sizes.', '<b>Advanced techniques:</b> flexible bronchoscope, intubating supraglottic airway, fibreoptic-compatible tubes and lighted stylet if available.', '<b>Emergency front-of-neck access:</b> scalpel, bougie, cuffed tube (or approved cricothyrotomy kit), antiseptic, syringe and local anaesthetic.', '<b>Support:</b> monitoring, drugs for induction/resuscitation, checklist, difficult-airway record and communication/call-for-help details.']),
P('All equipment must be checked regularly, with staff trained to follow a local difficult-airway algorithm. The priority is oxygenation, not repeated traumatic intubation attempts.')])

section(11,'Short note on hypokalaemia.',[
P('<b>Definition:</b> serum potassium below 3.5 mmol/L. It is mild 3.0-3.4, moderate 2.5-2.9 and severe below 2.5 mmol/L, or severe at any level if symptoms/ECG changes are present.'),
P('<b>Causes:</b> gastrointestinal loss (vomiting, diarrhoea), renal loss (diuretics, mineralocorticoid excess), poor intake, intracellular shift (alkalosis, insulin, beta-agonists) and hypomagnesaemia.'),
P('<b>Features:</b> weakness, cramps, ileus, polyuria and arrhythmia. ECG: flat/inverted T waves, ST depression, prominent U waves and prolonged QU interval.'),
P('<b>Management:</b> confirm and check magnesium, ECG and renal function; stop ongoing losses and treat the cause. Give oral potassium chloride when stable. Use IV potassium chloride with continuous ECG monitoring in severe, symptomatic or arrhythmic cases, using an infusion pump and institution-approved rates. Correct magnesium deficiency and avoid dextrose-containing solutions when rapid replacement is required because insulin can worsen hypokalaemia.')])

section(12,'Symptomatic bradycardia - write its management.',[
P('<b>Recognise symptomatic bradycardia:</b> heart rate usually below 50/min with hypotension, acutely altered mental status, shock, ischaemic chest discomfort or acute heart failure.'),
P('<b>Initial steps:</b> ABC approach, call for help, give oxygen if hypoxaemic, attach monitor/defibrillator, obtain IV/IO access, obtain 12-lead ECG if it does not delay treatment, and search for reversible causes (hypoxia, drugs, myocardial ischaemia, hyperkalaemia, raised vagal tone).'),
P('<b>Drug treatment:</b> atropine 1 mg IV bolus; repeat every 3-5 min to a maximum 3 mg. Atropine may be ineffective in high-grade infranodal block or transplanted hearts.'),
P('<b>If atropine ineffective or patient unstable:</b> start transcutaneous pacing without delay and/or infusion of dopamine 5-20 micrograms/kg/min or epinephrine 2-10 micrograms/min. Arrange expert consultation and transvenous pacing. Treat the specific cause. If pulseless, begin the cardiac-arrest algorithm immediately.'),
P('<i>Note:</i> This is the current adult ACLS-style dose. The 2015 AHA algorithm used atropine 0.5 mg IV every 3-5 min (maximum 3 mg), so state the expected edition in an examination if asked.')])

section(13,'Massive blood transfusion - define and enumerate complications.',[
P('<b>Definition:</b> replacement of one blood volume within 24 hours, conventionally 10 or more units of red cells in an adult within 24 hours. Practical trauma definitions also include 4 or more units within 1 hour with ongoing bleeding, or replacement of 50% blood volume in 3 hours.'),
P('<b>Complications:</b>'),
*bullets(['<b>Hypothermia</b> due to rapid infusion of cold blood.', '<b>Dilutional coagulopathy</b> from loss/dilution of platelets and clotting factors, with fibrinogen depletion.', '<b>Citrate toxicity causing hypocalcaemia</b> and reduced myocardial contractility; hypomagnesaemia may occur.', '<b>Hyperkalaemia</b> from stored red cells; later hypokalaemia may occur.', '<b>Acid-base disturbances:</b> metabolic acidosis from shock and later metabolic alkalosis as citrate is metabolised.', '<b>Volume overload, pulmonary oedema, TRALI, acute haemolytic reaction, transfusion-transmitted infection and DIC.']),
P('<b>Prevention/monitoring:</b> use warmed blood and fluids, a massive transfusion protocol with balanced components, early haemorrhage control, and serial temperature, ionised calcium, potassium, blood gas, coagulation and fibrinogen testing.')])

section(14,'WHO surgical safety checklist.',[
P('<b>Purpose:</b> The WHO Surgical Safety Checklist improves communication and verifies essential safety steps. A designated coordinator leads it with active participation by the team.'),
P('<b>1. Sign In - before induction of anaesthesia:</b> confirm patient identity, site, procedure and consent; mark site; check pulse oximeter; review allergy, difficult airway/aspiration risk and blood-loss risk; ensure anaesthesia machine/medication check is complete.'),
P('<b>2. Time Out - before skin incision:</b> all team members introduce themselves; reconfirm patient, site and procedure; surgeon reviews critical/unexpected steps, duration and blood loss; anaesthetist reviews patient-specific concerns; nurse confirms sterility, equipment and imaging; confirm prophylactic antibiotic within the appropriate time; confirm essential imaging displayed.'),
P('<b>3. Sign Out - before patient leaves operating room:</b> confirm procedure performed, instrument/sponge/needle counts, specimen labels, equipment problems and key concerns for recovery/postoperative plan.')])

section(15,'Adult chain of survival according to AHA 2015 guidelines.',[
P('The <b>2015 AHA adult out-of-hospital Chain of Survival</b> has five links:'),
*bullets(['<b>Immediate recognition of cardiac arrest and activation of the emergency response system.</b>', '<b>Early cardiopulmonary resuscitation (CPR) with emphasis on chest compressions.</b>', '<b>Rapid defibrillation.</b>', '<b>Basic and advanced emergency medical services.</b>', '<b>Advanced life support and post-cardiac-arrest care.</b>']),
P('For <b>in-hospital cardiac arrest</b>, the 2015 chain is: surveillance and prevention; recognition and activation; immediate high-quality CPR; rapid defibrillation; advanced resuscitation; and post-cardiac-arrest care.'),
P('<i>Exam note:</i> Newer AHA material includes recovery as an additional link. This answer intentionally follows the wording requested in the 2015 guideline.')])

story.append(PageBreak())
story.append(P('References used for study', Q))
story += [
P('1. Morgan and Mikhail’s Clinical Anesthesiology, 7th ed: anaesthesia machine safety systems, positioning, hypokalaemia and neuroanaesthesia topics.'),
P('2. Miller’s Anesthesia, 10th ed: airway assessment, sitting position, bradyarrhythmia and local anaesthetic toxicity topics.'),
P('3. Bailey & Love’s Short Practice of Surgery, 28th ed: perioperative hypothermia and transfusion complications.'),
P('4. World Health Organization. WHO Guidelines for Safe Surgery 2009: Safe Surgery Saves Lives.'),
P('5. American Heart Association. 2015 Guidelines Update for CPR and Emergency Cardiovascular Care. Modern dose note in Q12 reflects later ACLS updates.'),
Spacer(1,8), P('<b>Source note:</b> The uploaded photograph was treated as the question-paper source. The paper heading reads “B.Sc. Medical Technology (OT) 1st Year, Annual 2018, Applied Basic Sciences”, with 15 questions carrying 5 marks each.', S)
]

doc=SimpleDocTemplate(str(OUT), pagesize=A4, rightMargin=1.45*cm, leftMargin=1.45*cm, topMargin=1.45*cm, bottomMargin=1.35*cm, title='Applied Basic Sciences - Solved Answers', author='Orris')
doc.build(story, onFirstPage=header_footer, onLaterPages=header_footer)
print(OUT)

Successfully replaced 1 instance(s) of the string in '/tmp/workspace/applied-basic-sciences-solved/src/generate_pdf.py'