2-Day Pathology Exam Study Plan

from pptx import Presentation
from pptx.util import Inches, Pt, Emu
from pptx.dml.color import RGBColor
from pptx.enum.text import PP_ALIGN, MSO_ANCHOR
from pptx.util import Inches, Pt
from io import BytesIO

# ── Colour palette ──────────────────────────────────────────────
BG       = RGBColor(0x0D, 0x1B, 0x2A)   # deep navy
ACCENT1  = RGBColor(0x1A, 0x8F, 0xE3)   # bright blue (headings)
ACCENT2  = RGBColor(0xF7, 0xB7, 0x31)   # amber (labels / keywords)
ACCENT3  = RGBColor(0x2E, 0xCC, 0x71)   # green (bullet dots)
WHITE    = RGBColor(0xFF, 0xFF, 0xFF)
LIGHT    = RGBColor(0xCC, 0xE5, 0xFF)   # pale blue body text
CARD_BG  = RGBColor(0x14, 0x2D, 0x45)   # card background
DIVIDER  = RGBColor(0x1A, 0x8F, 0xE3)

W = Inches(13.333)
H = Inches(7.5)

prs = Presentation()
prs.slide_width  = W
prs.slide_height = H
blank = prs.slide_layouts[6]

# ── Helper functions ─────────────────────────────────────────────

def fill_bg(slide, color=BG):
    from pptx.util import Emu
    from pptx.oxml.ns import qn
    import lxml.etree as etree
    bg = slide.background
    fill = bg.fill
    fill.solid()
    fill.fore_color.rgb = color

def add_rect(slide, x, y, w, h, fill_color, line_color=None, line_width=None):
    shape = slide.shapes.add_shape(1, x, y, w, h)  # MSO_SHAPE_TYPE.RECTANGLE = 1
    shape.fill.solid()
    shape.fill.fore_color.rgb = fill_color
    if line_color:
        shape.line.color.rgb = line_color
        if line_width:
            shape.line.width = line_width
    else:
        shape.line.fill.background()
    return shape

def add_text(slide, text, x, y, w, h, size, bold=False, color=WHITE,
             align=PP_ALIGN.LEFT, italic=False, wrap=True):
    tb = slide.shapes.add_textbox(x, y, w, h)
    tf = tb.text_frame
    tf.word_wrap = wrap
    tf.margin_left  = Pt(2)
    tf.margin_right = Pt(2)
    tf.margin_top   = Pt(1)
    tf.margin_bottom= Pt(1)
    p = tf.paragraphs[0]
    p.alignment = align
    run = p.add_run()
    run.text = text
    run.font.size   = Pt(size)
    run.font.bold   = bold
    run.font.italic = italic
    run.font.color.rgb = color
    run.font.name = "Calibri"
    return tb

def add_multiline(slide, lines, x, y, w, h, size, color=LIGHT,
                  bold_first=False, label_color=ACCENT2, wrap=True):
    """lines: list of str or (label, value) tuples"""
    tb = slide.shapes.add_textbox(x, y, w, h)
    tf = tb.text_frame
    tf.word_wrap = wrap
    tf.margin_left  = Pt(2)
    tf.margin_right = Pt(2)
    tf.margin_top   = Pt(1)
    tf.margin_bottom= Pt(1)
    first = True
    for item in lines:
        if first:
            p = tf.paragraphs[0]
            first = False
        else:
            p = tf.add_paragraph()
        p.space_before = Pt(1)
        if isinstance(item, tuple):
            label, val = item
            r1 = p.add_run()
            r1.text = label + " "
            r1.font.size  = Pt(size)
            r1.font.bold  = True
            r1.font.color.rgb = label_color
            r1.font.name  = "Calibri"
            r2 = p.add_run()
            r2.text = val
            r2.font.size  = Pt(size)
            r2.font.color.rgb = color
            r2.font.name  = "Calibri"
        else:
            run = p.add_run()
            run.text = item
            run.font.size  = Pt(size)
            run.font.bold  = (bold_first and p == tf.paragraphs[0])
            run.font.color.rgb = color
            run.font.name  = "Calibri"
    return tb

def slide_header(slide, title, subtitle=None):
    fill_bg(slide)
    # top accent bar
    add_rect(slide, 0, 0, W, Inches(0.55), ACCENT1)
    add_text(slide, title, Inches(0.3), Inches(0.04), Inches(10), Inches(0.48),
             18, bold=True, color=WHITE, align=PP_ALIGN.LEFT)
    if subtitle:
        add_text(slide, subtitle, Inches(10.2), Inches(0.04), Inches(2.9), Inches(0.48),
                 11, bold=False, color=WHITE, align=PP_ALIGN.RIGHT)

def card(slide, x, y, w, h, title, lines, title_color=ACCENT2, font_size=8.5):
    add_rect(slide, x, y, w, h, CARD_BG, DIVIDER, Pt(0.75))
    # card title bar
    add_rect(slide, x, y, w, Inches(0.28), ACCENT1)
    add_text(slide, title, x+Pt(4), y+Pt(1), w-Pt(8), Inches(0.26),
             9.5, bold=True, color=WHITE, align=PP_ALIGN.LEFT)
    add_multiline(slide, lines, x+Pt(5), y+Inches(0.3), w-Pt(10),
                  h-Inches(0.32), font_size, color=LIGHT, label_color=ACCENT2)

# ══════════════════════════════════════════════════════════════════
# SLIDE 1 – TITLE SLIDE
# ══════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
fill_bg(s)
add_rect(s, 0, Inches(2.8), W, Inches(2.0), ACCENT1)
add_text(s, "PATHOLOGY", Inches(0.5), Inches(2.85), Inches(12), Inches(0.8),
         54, bold=True, color=WHITE, align=PP_ALIGN.CENTER)
add_text(s, "HIGH-YIELD EXAM CHEAT SHEET", Inches(0.5), Inches(3.65), Inches(12), Inches(0.6),
         22, bold=False, color=ACCENT2, align=PP_ALIGN.CENTER)
add_text(s, "10-Mark & 5-Mark Topics  |  Quick Reference for Exam Prep",
         Inches(0.5), Inches(4.4), Inches(12), Inches(0.5),
         13, color=LIGHT, align=PP_ALIGN.CENTER)
add_text(s, "Covers: General Pathology • Hematology • Systemic Pathology • Oncology • Genetics",
         Inches(0.5), Inches(5.2), Inches(12), Inches(0.4),
         10.5, color=LIGHT, align=PP_ALIGN.CENTER, italic=True)

# ══════════════════════════════════════════════════════════════════
# SLIDE 2 – CELL INJURY: NECROSIS + METAPLASIA + EDEMA
# ══════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
slide_header(s, "CELL INJURY  |  Necrosis • Metaplasia • Edema", "5-Mark Topics")

# Necrosis card
card(s, Inches(0.15), Inches(0.6), Inches(4.2), Inches(3.3), "TYPES OF NECROSIS", [
    ("Coagulative:", "Ischemia (except brain); ghost outline preserved; e.g. MI, renal infarct"),
    ("Liquefactive:", "Brain infarct, abscess; tissue dissolved by enzymes"),
    ("Caseous:", "TB; cheese-like; granuloma with Langhans giant cells"),
    ("Fat:", "Acute pancreatitis; saponification; chalky-white deposits"),
    ("Fibrinoid:", "Immune vasculitis, malignant HTN; homogeneous pink deposits"),
    ("Gangrenous:", "Dry = coagulative; Wet = + liquefactive (infection)"),
])

# Metaplasia card
card(s, Inches(0.15), Inches(4.0), Inches(4.2), Inches(3.1), "METAPLASIA", [
    ("Definition:", "Reversible replacement of one differentiated cell by another"),
    ("Squamous:", "Respiratory tract (smokers), cervix (ectocervix), bladder"),
    ("Intestinal:", "Barrett esophagus (GERD → goblet cells); stomach (H. pylori)"),
    ("Key:", "Reversible; precursor to dysplasia; caused by chronic irritation"),
])

# Edema card
card(s, Inches(4.5), Inches(0.6), Inches(4.4), Inches(3.0), "EDEMA — MECHANISMS", [
    ("↑Hydrostatic P:", "Congestive heart failure, venous obstruction"),
    ("↓Oncotic P:", "Hypoalbuminemia (liver failure, nephrotic syndrome, malnutrition)"),
    ("↑Vascular perm:", "Inflammation, burns — protein-rich exudate"),
    ("Lymphatic obstruction:", "Elephantiasis (filariasis), post-mastectomy"),
    ("Na+ retention:", "Renal failure, hyperaldosteronism"),
    ("Pitting vs Non-pitting:", "Pitting = cardiac/renal; Non-pitting = lymphedema/myxedema"),
])

# Transudate vs Exudate
card(s, Inches(4.5), Inches(3.75), Inches(4.4), Inches(3.35), "TRANSUDATE vs EXUDATE", [
    ("",             "TRANSUDATE          EXUDATE"),
    ("Protein:",     "< 3 g/dL            > 3 g/dL"),
    ("LDH:",         "Low                 High"),
    ("Appearance:",  "Clear               Cloudy/turbid"),
    ("Cells:",       "Few                 Many (PMNs/lymphs)"),
    ("Cause:",       "CHF, cirrhosis,     Infection,"),
    ("",             "nephrotic syn.      inflammation"),
    ("Light's:",     "Both criteria absent Both present"),
])

# Inflammation overview
card(s, Inches(9.05), Inches(0.6), Inches(4.1), Inches(6.5), "INFLAMMATION — VASCULAR & CELLULAR EVENTS", [
    ("VASCULAR:", ""),
    ("1.", "Transient vasoconstriction"),
    ("2.", "Vasodilation (histamine, NO) → ↑ blood flow"),
    ("3.", "↑Vascular permeability → exudate"),
    ("4.", "Stasis → margination of WBCs"),
    ("CELLULAR:", ""),
    ("5.", "Margination → Rolling (selectins)"),
    ("6.", "Adhesion (integrins-ICAM)"),
    ("7.", "Transmigration/Diapedesis (CD31/PECAM)"),
    ("8.", "Chemotaxis (C5a, IL-8, LTB4, bacterial products)"),
    ("9.", "Phagocytosis → Killing (ROS, MPO, defensins)"),
    ("Mediators:", "Histamine, PGs, LTs, C3a/C5a, IL-1/TNF, NO"),
    ("Chronic:", "Lymphs, macrophages, plasma cells; granulomas"),
], font_size=8)

# ══════════════════════════════════════════════════════════════════
# SLIDE 3 – SHOCK + THROMBOSIS + INFARCTION
# ══════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
slide_header(s, "SHOCK  |  Thrombosis  |  Infarction  |  Atherosclerosis", "5M + 10M Topics")

card(s, Inches(0.15), Inches(0.6), Inches(4.3), Inches(6.5), "SHOCK — CLASSIFY + PATHOGENESIS", [
    ("HYPOVOLEMIC:", "↓ blood volume (hemorrhage, burns, dehydration); ↓CO, ↑SVR"),
    ("CARDIOGENIC:", "↓ pump function (MI, arrhythmia, tamponade); ↓CO, ↑SVR"),
    ("DISTRIBUTIVE:", "Vasodilation → ↓SVR; subtypes:"),
    ("  Septic:", "Gram -ve LPS → TNF/IL-1 → NO → vasodilation"),
    ("  Anaphylactic:", "IgE → mast cell → histamine"),
    ("  Neurogenic:", "Loss of vasomotor tone"),
    ("OBSTRUCTIVE:", "PE, tension pneumothorax → ↑afterload"),
    ("STAGES:", ""),
    ("1. Compensated:", "↑HR, ↑SVR, normal BP"),
    ("2. Progressive:", "Acidosis, ↓urine output, confusion"),
    ("3. Irreversible:", "MOF, DIC, death"),
    ("Shock kidney:", "ATN (acute tubular necrosis)"),
    ("Shock lung:", "ARDS (diffuse alveolar damage)"),
    ("Shock liver:", "Centrilobular necrosis"),
], font_size=8)

card(s, Inches(4.6), Inches(0.6), Inches(4.2), Inches(3.0), "THROMBOSIS — VIRCHOW'S TRIAD", [
    ("1. Endothelial injury:", "Atherosclerosis, trauma, inflammation"),
    ("2. Stasis:", "Immobilization, cardiac failure, varicose veins"),
    ("3. Hypercoagulability:", "Factor V Leiden, OCP, malignancy, antiphospholipid syndrome"),
    ("Fate:", "Resolution, organization, recanalization, embolism, calcification"),
    ("DVT:", "Femoral/popliteal vein; Homan's sign; risk → PE"),
])

card(s, Inches(4.6), Inches(3.75), Inches(4.2), Inches(3.35), "INFARCTION — TYPES + EXAMPLES", [
    ("WHITE (Anemic):", "Solid organs (heart, kidney, spleen); arterial occlusion; coagulative necrosis"),
    ("RED (Hemorrhagic):", "Loose tissue (lung, gut); venous occlusion OR dual blood supply; red due to reperfusion"),
    ("Lung infarct:", "Red; wedge-shaped; pulmonary embolism (>60% from DVT)"),
    ("Renal infarct:", "White; wedge-shaped; coagulative necrosis"),
    ("Brain infarct:", "Liquefactive necrosis; pale or hemorrhagic"),
    ("Intestinal:", "Red; venous; haemorrhagic necrosis; peritonitis"),
])

card(s, Inches(9.0), Inches(0.6), Inches(4.15), Inches(6.5), "ATHEROSCLEROSIS + MI", [
    ("PATHOGENESIS:", ""),
    ("1.", "Endothelial injury (HTN, smoking, hyperlipidemia)"),
    ("2.", "LDL accumulation → oxidized LDL"),
    ("3.", "Monocyte recruitment → macrophage → foam cells"),
    ("4.", "Fatty streak → fibrous plaque → complicated plaque"),
    ("5.", "Plaque rupture → thrombus → MI/stroke"),
    ("Risk factors:", "HTN, DM, smoking, dyslipidemia, obesity, FH"),
    ("MYOCARDIAL INFARCTION:", ""),
    ("Most common:", "LAD (40%), RCA (30%), LCx (20%)"),
    ("0–4h:", "No gross change; wavy fibres on EM"),
    ("4–12h:", "Coagulative necrosis begins; hypereosinophilic"),
    ("1–3 days:", "PMN infiltration"),
    ("3–7 days:", "Macrophages (yellow softening)"),
    ("1–3 wk:", "Granulation tissue; risk of rupture"),
    ("Months:", "Dense scar"),
    ("Enzymes:", "Troponin I/T (most specific, rises 4-6h, peaks 24h); CK-MB rises 4-8h; LDH rises 12-24h"),
    ("Complications:", "Arrhythmia, cardiogenic shock, rupture, pericarditis (Dressler), mural thrombus, aneurysm"),
], font_size=7.8)

# ══════════════════════════════════════════════════════════════════
# SLIDE 4 – WOUND HEALING + GENETICS + HAEMOPHILIA
# ══════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
slide_header(s, "WOUND HEALING  |  Genetics  |  Haemophilia", "5-Mark Topics")

card(s, Inches(0.15), Inches(0.6), Inches(4.3), Inches(3.5), "WOUND HEALING — PHASES", [
    ("PRIMARY INTENTION (clean wound, sutured):", ""),
    ("Day 0-3:", "Hemostasis → Inflammation (PMNs, then macrophages)"),
    ("Day 3-5:", "Proliferation: fibroblasts, angiogenesis, re-epithelialization"),
    ("Day 5-7:", "Granulation tissue; collagen III deposited"),
    ("Weeks:", "Remodeling: collagen III → collagen I; tensile strength ↑"),
    ("Max strength:", "~80% of original at 3 months"),
    ("SECONDARY:", "Open wound; heals by contraction + granulation; larger scar"),
])

card(s, Inches(0.15), Inches(4.2), Inches(4.3), Inches(2.9), "FACTORS AFFECTING WOUND HEALING", [
    ("LOCAL factors:", "Infection, foreign body, poor blood supply, radiation, wound size"),
    ("SYSTEMIC factors:", "DM (↓neutrophil fn), malnutrition (↓collagen), steroids, age, Vit C deficiency (↓collagen hydroxylation), zinc deficiency"),
    ("Growth factors:", "EGF, PDGF, TGF-β, VEGF (angiogenesis), FGF"),
    ("Complications:", "Keloid (beyond wound), hypertrophic scar (within), dehiscence, incisional hernia"),
])

card(s, Inches(4.6), Inches(0.6), Inches(4.2), Inches(3.1), "DOWN SYNDROME (Trisomy 21)", [
    ("Genetics:", "Trisomy 21 (nondisjunction 95%); Robertsonian translocation (4%); Mosaic (1%)"),
    ("Maternal age:", "Risk ↑ with age (especially >35 yrs)"),
    ("Features:", "Flat face, epicanthal folds, single palmar crease, hypotonia, short stature, intellectual disability"),
    ("Cardiac:", "VSD/ASD/AVSD (40-50%)"),
    ("Leukemia risk:", "↑ AML (esp. AMKL in neonates), ALL in children"),
    ("Alzheimer risk:", "↑ (APP gene on chromosome 21)"),
    ("Screening:", "nuchal translucency, triple test (↑AFP? No — ↓AFP, ↑hCG, ↓estriol)"),
])

card(s, Inches(4.6), Inches(3.75), Inches(4.2), Inches(3.35), "TURNER SYNDROME (45,X)", [
    ("Genetics:", "45,X (most common); mosaicism 45,X/46,XX"),
    ("Only in:", "Females"),
    ("Features:", "Short stature, webbed neck, low hairline, shield chest, wide-spaced nipples, cubitus valgus"),
    ("Gonads:", "Streak gonads → primary amenorrhea, infertility"),
    ("Cardiac:", "Bicuspid aortic valve, coarctation of aorta (most common)"),
    ("Hormones:", "↑FSH, ↑LH (hypergonadotropic hypogonadism), ↓estrogen"),
    ("Lymphedema:", "Hands/feet at birth → pedal edema"),
])

card(s, Inches(9.0), Inches(0.6), Inches(4.15), Inches(6.5), "HAEMOPHILIA", [
    ("HAEMOPHILIA A:", "Factor VIII deficiency; X-linked recessive"),
    ("HAEMOPHILIA B:", "Factor IX deficiency (Christmas disease); X-linked recessive"),
    ("Inheritance:", "Males affected; females carriers"),
    ("Severity:", "Severe < 1%, Moderate 1-5%, Mild 5-40%"),
    ("Lab findings:", "↑PTT (intrinsic pathway); normal PT, BT, platelet count"),
    ("Features:", "Hemarthrosis (knee MC), deep tissue bleeds, intracranial bleed, prolonged post-op bleeding"),
    ("Treatment A:", "Factor VIII concentrate (recombinant); DDAVP for mild"),
    ("Treatment B:", "Factor IX concentrate"),
    ("Inhibitors:", "Anti-Factor VIII IgG antibodies (complication of treatment)"),
    ("vWD diff:", "von Willebrand disease = ↑BT + ↑PTT; affects platelet adhesion"),
], font_size=8.5)

# ══════════════════════════════════════════════════════════════════
# SLIDE 5 – HEMATOLOGY: ANEMIA + TRANSFUSION + CML
# ══════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
slide_header(s, "HEMATOLOGY  |  Anemia  |  Transfusion Reactions  |  CML vs Leukemoid", "10M + 5M Topics")

card(s, Inches(0.15), Inches(0.6), Inches(4.3), Inches(6.5), "IRON DEFICIENCY ANEMIA (IDA)", [
    ("Definition:", "Anemia due to insufficient iron for Hb synthesis"),
    ("CAUSES:", ""),
    ("Blood loss:", "Menorrhagia (women), GI bleed (men/elderly) — MC cause"),
    ("↓Intake:", "Poor diet, vegetarians"),
    ("↓Absorption:", "Celiac disease, post-gastrectomy"),
    ("↑Demand:", "Pregnancy, infancy"),
    ("STAGES:", ""),
    ("1. Iron depletion:", "↓Ferritin; normal Hb"),
    ("2. Iron-deficient erythropoiesis:", "↓Serum iron, ↑TIBC; normal Hb"),
    ("3. IDA:", "↓Hb, ↓MCV, ↓MCH"),
    ("LAB FINDINGS:", ""),
    ("CBC:", "↓Hb, microcytic hypochromic, ↑RDW, pencil cells"),
    ("Iron studies:", "↓Serum iron, ↓ferritin, ↑TIBC, ↓transferrin saturation"),
    ("Smear:", "Microcytes, hypochromia, target cells, pencil cells, poikilocytosis"),
    ("BM:", "Absent iron stores (Prussian blue stain)"),
    ("Symptoms:", "Fatigue, pallor, koilonychia, glossitis, angular stomatitis, pica"),
    ("Treat:", "Oral ferrous sulfate; IV iron if malabsorption; treat cause"),
], font_size=7.8)

card(s, Inches(4.6), Inches(0.6), Inches(4.2), Inches(6.5), "MEGALOBLASTIC ANEMIA", [
    ("Cause:", "B12 (cobalamin) or Folate deficiency → impaired DNA synthesis → large cells"),
    ("B12 causes:", "Pernicious anemia (anti-IF antibodies MC), gastrectomy, ileal disease, vegan diet, Diphyllobothrium"),
    ("Folate causes:", "Poor diet, alcoholism, pregnancy (↑demand), methotrexate/trimethoprim (inhibit DHFR), malabsorption"),
    ("B12 unique:", "Neurological features — subacute combined degeneration (posterior + lateral columns)"),
    ("LAB FINDINGS:", ""),
    ("CBC:", "↑MCV (>100 fL), ↑MCH, low Hb, leukopenia, thrombocytopenia (pancytopenia)"),
    ("Smear:", "Macro-ovalocytes, hypersegmented neutrophils (≥5 lobes in >5%), teardrop cells"),
    ("Serum:", "↓B12 or ↓folate, ↑homocysteine (both); ↑methylmalonic acid (B12 only — most specific)"),
    ("Schilling test:", "Identifies B12 malabsorption cause (historical)"),
    ("BM:", "Hypercellular, megaloblasts (large cells with open chromatin), giant metamyelocytes"),
    ("Treat B12:", "IM hydroxocobalamin (if pernicious anemia / neurological)"),
    ("Treat folate:", "Oral folic acid; always give B12 first to avoid masking neuropathy"),
], font_size=7.8)

card(s, Inches(9.0), Inches(0.6), Inches(4.15), Inches(3.2), "TRANSFUSION REACTIONS", [
    ("ACUTE HEMOLYTIC:", "ABO mismatch; IgM → complement → intravascular hemolysis; fever, back/flank pain, hemoglobinuria, DIC; STOP transfusion immediately"),
    ("FEBRILE (FNHTR):", "Anti-HLA antibodies vs donor WBCs; fever + chills; MC reaction; no hemolysis"),
    ("ALLERGIC:", "IgE vs donor plasma proteins; urticaria → anaphylaxis (in IgA-deficient patients)"),
    ("TRALI:", "Transfusion-Related Acute Lung Injury; anti-HLA in donor plasma; ARDS within 6h"),
    ("TACO:", "Transfusion-Associated Circulatory Overload; pulmonary edema; treat with diuretics"),
    ("DSTR:", "Delayed hemolytic (3-10 days); extravascular; ↓Hb; anti-Kidd, anti-Duffy"),
])

card(s, Inches(9.0), Inches(3.95), Inches(4.15), Inches(3.15), "LEUKEMOID REACTION vs CML", [
    ("",              "LEUKEMOID RXN    CML"),
    ("WBC:",          "↑↑ (>50,000)     ↑↑↑ (>100,000)"),
    ("LAP score:",    "↑↑ HIGH          ↓ LOW (key diff)"),
    ("Ph chromosome:","Absent           Present (BCR-ABL t(9;22))"),
    ("Blasts:",       "Absent           Present (basophilia++)"),
    ("Cause:",        "Infection, stress Myeloproliferative"),
    ("Splenomegaly:", "Mild             Massive"),
    ("Treat:",        "Treat cause      Imatinib (Gleevec)"),
])

# ══════════════════════════════════════════════════════════════════
# SLIDE 6 – RENAL: NEPHROTIC + RENAL FAILURE + RCC
# ══════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
slide_header(s, "RENAL PATHOLOGY  |  Nephrotic Syndrome  |  Renal Failure  |  Tumors", "10M + 5M Topics")

card(s, Inches(0.15), Inches(0.6), Inches(4.3), Inches(6.5), "NEPHROTIC SYNDROME", [
    ("DEFINITION:", ">3.5 g protein/day, hypoalbuminemia, edema, hyperlipidemia, lipiduria"),
    ("CAUSES:", ""),
    ("Primary:", "Minimal Change Disease (MCD) — MC in children; FSGS — MC in adults/HIV; Membranous GN; MPGN"),
    ("Secondary:", "DM (Kimmelstiel-Wilson nodules), SLE (wire loop), amyloidosis, HBV/HCV, drugs (NSAID, gold, penicillamine)"),
    ("MINIMAL CHANGE DISEASE:", ""),
    ("LM:", "Normal (no change on light microscopy)"),
    ("EM:", "Fusion/effacement of podocyte foot processes (key finding)"),
    ("IF:", "Negative"),
    ("Responds to:", "Steroids (excellent response); MC cause nephrotic in children"),
    ("MEMBRANOUS GN:", ""),
    ("LM:", "Spike & dome pattern (silver stain); GBM thickening"),
    ("EM:", "Subepithelial deposits"),
    ("IF:", "IgG + C3 granular"),
    ("Cause:", "Primary (PLA2R antibodies) or secondary (Hep B, SLE, drugs)"),
    ("LAB INVESTIGATIONS:", ""),
    ("Urine:", "24h protein >3.5g; lipiduria; fatty casts; oval fat bodies"),
    ("Bloods:", "↓albumin, ↑cholesterol, ↑TG, ↓total protein"),
    ("Renal biopsy:", "Gold standard for classification"),
    ("Complications:", "Infection (↓IgG), thrombosis (↓antithrombin III), hyperlipidemia → CVD"),
], font_size=7.5)

card(s, Inches(4.6), Inches(0.6), Inches(4.2), Inches(3.1), "RENAL FAILURE", [
    ("PRE-RENAL:", "↓ Renal perfusion; BUN:Cr > 20; ↑urine osmolality; ↑urine Na < 20; FENa < 1%"),
    ("INTRINSIC RENAL:", "ATN (ischemia/nephrotoxins MC); BUN:Cr normal (10-15); urine Na >40; muddy brown casts; FENa >2%"),
    ("POST-RENAL:", "Obstruction (BPH, stone, tumor); BUN:Cr > 20 initially"),
    ("CRF features:", "↓GFR, uremia, hyperkalemia, metabolic acidosis, anemia (↓EPO), renal osteodystrophy (↓vit D → ↑PTH)"),
    ("ATN stages:", "Oliguric → Diuretic → Recovery"),
])

card(s, Inches(4.6), Inches(3.75), Inches(4.2), Inches(3.35), "RENAL TUMORS", [
    ("WILMS TUMOR (Nephroblastoma):", "Children 2-5 yrs; WT1 gene; triad: abdominal mass, hematuria, HTN; blastemal + stromal + epithelial triphasic; excellent prognosis"),
    ("RENAL CELL CARCINOMA (RCC):", ""),
    ("MC type:", "Clear cell (75%) — VHL mutation; yellow on cut section"),
    ("Papillary:", "Trisomy 7,17; sporadic or hereditary"),
    ("Chromophobe:", "Best prognosis"),
    ("Classic triad:", "Hematuria + flank pain + palpable mass (late finding)"),
    ("Paraneoplastic:", "Polycythemia (EPO), hypercalcemia (PTHrP), HTN"),
    ("Spread:", "Renal vein → IVC (tumor thrombus); mets to lung + bone"),
])

card(s, Inches(9.0), Inches(0.6), Inches(4.15), Inches(6.5), "BONE PATHOLOGY: RICKETS, OSTEOPOROSIS, OSTEOMYELITIS", [
    ("RICKETS (Vit D deficiency — children):", ""),
    ("Features:", "Bow legs, rachitic rosary (costochondral junction), craniotabes, delayed fontanelle closure, Harrison sulcus"),
    ("Labs:", "↓Ca, ↓PO4, ↑ALP, ↑PTH; X-ray: cupping/fraying of metaphysis"),
    ("Causes:", "↓dietary Vit D, ↓sun, malabsorption, renal failure (type 1α-hydroxylase↓)"),
    ("OSTEOPOROSIS:", ""),
    ("Type I:", "Postmenopausal; ↓estrogen → ↑osteoclast activity; trabecular bone loss; vertebral + Colles fracture"),
    ("Type II:", "Senile (>70); cortical + trabecular; hip fracture"),
    ("Diagnosis:", "DEXA scan; T-score < -2.5"),
    ("Labs:", "Normal Ca, PO4, ALP (unlike Paget's)"),
    ("Treat:", "Bisphosphonates (1st line), Ca + Vit D, SERMs (raloxifene), denosumab"),
    ("OSTEOMYELITIS:", ""),
    ("Acute:", "Staph aureus MC; long bone metaphysis; hematogenous spread"),
    ("Chronic:", "Sequestrum = dead bone; Involucrum = periosteal new bone; Brodie abscess = localized walled-off"),
    ("In sickle cell:", "Salmonella MC (unusual)"),
    ("Diabetic:", "Polymicrobial; foot bones; Pseudomonas"),
], font_size=7.5)

# ══════════════════════════════════════════════════════════════════
# SLIDE 7 – PULMONARY + INFECTIOUS DISEASES
# ══════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
slide_header(s, "PULMONARY + INFECTIOUS DISEASES  |  TB • Pneumonia • Asthma • Meningitis", "5-Mark Topics")

card(s, Inches(0.15), Inches(0.6), Inches(4.3), Inches(3.3), "TUBERCULOSIS", [
    ("Organism:", "Mycobacterium tuberculosis; AFB (Ziehl-Neelsen stain)"),
    ("PRIMARY TB:", "Ghon focus (mid-lower lobe) + lymph node = Ghon complex"),
    ("SECONDARY TB:", "Upper lobe reactivation; Assmann/Simon focus; cavitation"),
    ("Pathology:", "Caseous necrosis; epithelioid granuloma + Langhans giant cells + lymphocytes"),
    ("Miliary TB:", "Hematogenous spread; millet-seed lesions throughout"),
    ("Complications:", "Cavitation, empyema, pneumothorax, bronchopleural fistula, amyloidosis"),
    ("Lab:", "Mantoux/TST; IGRA (Quantiferon); AFB smear + culture; Lowenstein-Jensen medium"),
])

card(s, Inches(0.15), Inches(4.0), Inches(4.3), Inches(3.1), "PNEUMONIA", [
    ("LOBAR PNEUMONIA (Strep pneumoniae MC):", "Consolidation of entire lobe; 4 stages: congestion → red hepatization → grey hepatization → resolution"),
    ("BRONCHOPNEUMONIA:", "Patchy; multi-lobular; elderly/infants; Staph, Strep, H. influenzae; no stages"),
    ("Interstitial:", "Atypical (Mycoplasma, Legionella, viral); ground-glass on CT"),
    ("Aspiration:", "Lower lobe/right middle lobe; anaerobes; abscess"),
    ("Complications:", "Empyema, lung abscess, bacteremia, fibrous pleuritis, ARDS"),
])

card(s, Inches(4.6), Inches(0.6), Inches(4.2), Inches(3.0), "ASTHMA", [
    ("Type:", "Reversible obstructive airway disease; bronchospasm + mucus + inflammation"),
    ("Extrinsic (Atopic):", "IgE-mediated (Type I HSR); triggers: allergens; ↑eosinophils, ↑IgE"),
    ("Intrinsic:", "Non-atopic; cold/exercise/infection/drugs (aspirin)"),
    ("Histology:", "Curschmann spirals (mucus plugs), Charcot-Leyden crystals (eosinophil breakdown), Creola bodies, BM thickening, goblet cell hyperplasia"),
    ("PFT:", "↓FEV1, ↓FEV1/FVC; reversible with bronchodilator"),
    ("Severe attack:", "Status asthmaticus; silent chest = DANGER"),
])

card(s, Inches(4.6), Inches(3.7), Inches(4.2), Inches(3.4), "MENINGITIS", [
    ("",          "BACTERIAL             VIRAL"),
    ("CSF appear:", "Turbid/purulent       Clear"),
    ("Protein:",  "↑↑ (>100mg/dL)        ↑ mildly"),
    ("Glucose:",  "↓↓ (<40mg/dL)         Normal"),
    ("Cells:",    "PMNs (1000s)          Lymphocytes"),
    ("Org.(adult):", "N. meningitidis,    Enteroviruses,"),
    ("",          "S. pneumoniae         HSV"),
    ("Org.(neonate):", "GBS, E. coli, Listeria"),
    ("Treat:",    "Ceftriaxone + Dexa    Supportive"),
    ("TB meningitis:", "Lymphocytes, ↑protein, ↓glucose, pellicle formation"),
])

card(s, Inches(9.0), Inches(0.6), Inches(4.15), Inches(6.5), "LIVER: HEPATITIS + CIRRHOSIS", [
    ("CHRONIC HEPATITIS:", ""),
    ("Definition:", ">6 months liver inflammation"),
    ("Causes:", "HBV, HCV (MC cause chronic), HDV, AIH, Wilson, hemochromatosis, drug (INH, methyldopa)"),
    ("HBV markers:", "HBsAg (surface), HBeAg (replication/infectivity), Anti-HBc IgM (acute); Anti-HBs (immunity)"),
    ("HCV:", "RNA virus; no vaccine; MC cause cirrhosis in West; cryoglobulinemia, membranous GN"),
    ("Histology:", "Piecemeal necrosis (interface hepatitis), portal lymphocytes, bridging fibrosis → cirrhosis"),
    ("CIRRHOSIS:", ""),
    ("Definition:", "Irreversible diffuse fibrosis + regenerative nodules"),
    ("Micronodular:", "Alcoholic (uniform <3mm nodules); Mallory hyaline bodies; centrilobular fibrosis"),
    ("Macronodular:", "Viral (HBV/HCV), Wilson, hemochromatosis (>3mm nodules)"),
    ("Complications:", "Portal HTN, ascites, esophageal varices, caput medusae, splenomegaly (hypersplenism), HE, SBP, HCC"),
    ("Labs:", "↑AST/ALT (AST:ALT >2 in alcohol), ↑bilirubin, ↑PT, ↓albumin, ↓platelets"),
    ("Alcohol:", "AST:ALT >2:1 (key); GGT elevated"),
], font_size=7.8)

# ══════════════════════════════════════════════════════════════════
# SLIDE 8 – GI ONCOLOGY: STOMACH + PEPTIC ULCER
# ══════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
slide_header(s, "GI PATHOLOGY  |  Carcinoma Stomach  |  Peptic Ulcer Disease", "10M Topics")

card(s, Inches(0.15), Inches(0.6), Inches(6.3), Inches(6.5), "CARCINOMA OF STOMACH", [
    ("ETIOLOGY:", "H. pylori (MC), dietary nitrosamines, smoked food, ↓fresh veg, smoking, EBV, blood group A, intestinal metaplasia, pernicious anemia, gastric adenoma"),
    ("PATHOGENESIS:", "H. pylori → chronic gastritis → atrophy → intestinal metaplasia → dysplasia → carcinoma"),
    ("LAUREN CLASSIFICATION:", ""),
    ("Intestinal type:", "Glandular; well-differentiated; blood-borne spread (liver); associated with H. pylori + intestinal metaplasia; better prognosis"),
    ("Diffuse type:", "Poorly differentiated; SIGNET RING CELLS; linitis plastica (leather bottle stomach); CDH1 (E-cadherin) mutation; peritoneal spread; worse prognosis"),
    ("SITES:", "Antrum/pylorus MC (50%), lesser curvature, cardia"),
    ("GROSS MORPHOLOGY:", ""),
    ("Early:",  "Confined to mucosa/submucosa (even with lymph node mets in Japan)"),
    ("Fungating:", "Polypoid, into lumen"),
    ("Ulcerating:", "Raised irregular edges (vs benign = punched out)"),
    ("Infiltrating:", "Linitis plastica — diffuse type; rigid, thick stomach wall"),
    ("MICROSCOPY:", "Intestinal: tubular/papillary glands; Diffuse: signet ring cells (mucin pushes nucleus aside)"),
    ("SPREAD:", "Direct to pancreas/liver; Lymph: Virchow's node (left supraclavicular); Transcoelomic: Krukenberg tumor (ovary), Blumer shelf (pouch of Douglas); Hematogenous: liver"),
    ("STAGING:", "TNM; 5yr survival: early >90%, advanced <15%"),
    ("PARANEOPLASTIC:", "Acanthosis nigricans, Leser-Trélat sign (sudden ↑seborrheic keratoses)"),
], font_size=7.8)

card(s, Inches(6.65), Inches(0.6), Inches(6.5), Inches(6.5), "PEPTIC ULCER DISEASE", [
    ("TYPES:", "Duodenal ulcer (DU): 1st part duodenum; Gastric ulcer (GU): lesser curvature antrum"),
    ("H. PYLORI ROLE:", "Damages mucosa → ↓bicarbonate; urease → NH3 → alkaline microenvironment; CagA/VacA toxins"),
    ("DU vs GU:", ""),
    ("DU:", "↑acid production; H. pylori in antrum; pain relieved by food; more common; no malignant potential"),
    ("GU:", "Normal/↓acid; pain worsened by food; must biopsy (malignant potential); H. pylori + NSAID"),
    ("NSAID MECHANISM:", "Inhibit COX-1 → ↓PGE2 → ↓mucus + bicarbonate + blood flow → ulcer"),
    ("GROSS MORPHOLOGY:", ""),
    ("Benign ulcer:", "Punched-out, smooth, regular margins; mucosal folds radiate to edge"),
    ("Malignant:", "Irregular, raised, everted edges; necrotic base; folds DON'T reach edge"),
    ("HISTOLOGY:", "4 zones: fibrinous exudate → fibrinoid necrosis → granulation tissue → fibrosis (base)"),
    ("CLINICAL FEATURES:", "Epigastric pain; DU: hunger pain at night (2-3 AM); heartburn, nausea, haematemesis, melaena"),
    ("INVESTIGATIONS:", "Urea breath test (H. pylori); Endoscopy (gold std); barium meal; H. pylori stool antigen; CLO test"),
    ("COMPLICATIONS:", ""),
    ("Perforation:", "MC emergency; anterior DU; board-like rigid abdomen; air under diaphragm on CXR"),
    ("Haemorrhage:", "MC complication; haematemesis/melaena; posterior DU → gastroduodenal artery"),
    ("Pyloric stenosis:", "Repeated scarring → narrowing; projectile vomiting; succussion splash"),
    ("Malignant change:", "GU only (very rare); never DU"),
    ("Penetration:", "Into pancreas (back pain); pancreatitis"),
    ("Treatment:", "PPI + clarithromycin + amoxicillin (triple therapy 7-14d); H2 blockers; Surgery for complications"),
], font_size=7.5)

# ══════════════════════════════════════════════════════════════════
# SLIDE 9 – BREAST + CERVIX + PCOD
# ══════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
slide_header(s, "FEMALE PATHOLOGY  |  Breast Ca  |  Cervical Ca  |  PCOD  |  Ovarian Tumors", "10M Topics")

card(s, Inches(0.15), Inches(0.6), Inches(4.3), Inches(6.5), "CARCINOMA OF BREAST", [
    ("RISK FACTORS:", "Female, age>50, BRCA1/BRCA2, FH, early menarche, late menopause, nulliparity, OCP/HRT, obesity, radiation, atypical hyperplasia"),
    ("BRCA1 (chr 17):", "↑Breast + ovarian Ca; triple negative tumors"),
    ("BRCA2 (chr 13):", "↑Breast (male also) + pancreatic Ca"),
    ("TYPES:", ""),
    ("IDC NOS:", "Invasive Ductal Carcinoma (MC, 70%); firm gritty mass; stellate/spiculate on mammogram"),
    ("ILC:", "Invasive Lobular Carcinoma (10%); single file/Indian file pattern; bilateral"),
    ("DCIS:", "Ductal CIS; comedo type (central necrosis, calcifications); pre-invasive"),
    ("Medullary:", "Large cells, lymphocyte-rich; BRCA1; better prognosis"),
    ("Mucinous:", "Mucin-producing; older women; better prognosis"),
    ("Inflammatory:", "Dermal lymphatic invasion; peau d'orange; worst prognosis"),
    ("PAGET DISEASE OF NIPPLE:", "Intraepidermal spread of ductal adenocarcinoma; eczematous nipple; Paget cells (large, pale, clear halo); always underlying DCIS/IDC"),
    ("GRADING (Nottingham):", "Tubule formation + nuclear pleomorphism + mitotic count; Grade I (low), II (intermediate), III (high)"),
    ("STAGING:", "TNM; sentinel lymph node biopsy"),
    ("RECEPTORS:", "ER+/PR+ (60%): respond to tamoxifen/aromatase inhibitors; HER2+ (20%): trastuzumab; Triple negative: BRCA1, chemo only"),
    ("SPREAD:", "Axillary LN (MC), bone, lung, liver, brain; Peau d'orange = skin lymphatic blockage"),
], font_size=7.5)

card(s, Inches(4.6), Inches(0.6), Inches(4.2), Inches(3.3), "CARCINOMA CERVIX", [
    ("Etiology:", "HPV 16 (SCC, MC) & HPV 18 (adenoCA); multiple sexual partners, early intercourse, smoking, immunosuppression"),
    ("Site:", "Squamocolumnar junction (transformation zone)"),
    ("CIN progression:", "CIN I → II → III → CIS → Invasive Ca (years)"),
    ("Types:", "Squamous Cell Ca (80%) > Adenocarcinoma (15%)"),
    ("Screening:", "Pap smear (exfoliative cytology); HPV co-testing; colposcopy → biopsy"),
    ("Pap smear findings:", "Koilocytes (perinuclear halo, HPV effect), dysplastic cells"),
    ("Spread:", "Direct (bladder, rectum, vagina); LN; hematogenous late"),
    ("Treatment:", "CIN: LEEP/cryotherapy; Invasive: surgery + chemoradiation; Vaccine: HPV 4-valent/9-valent"),
])

card(s, Inches(4.6), Inches(4.0), Inches(4.2), Inches(3.1), "PCOD (Polycystic Ovarian Disease)", [
    ("Definition:", "Chronic anovulation + hyperandrogenism; MC endocrine disorder in women of reproductive age"),
    ("Pathogenesis:", "↑LH (high LH:FSH >2:1) → ↑androgen (theca cells) → ↑peripheral estrogen (aromatization) → ↓FSH → no follicle maturation → cysts"),
    ("Features:", "Oligomenorrhea/amenorrhea, hirsutism, acne, obesity, infertility, acanthosis nigricans (insulin resistance)"),
    ("Gross:", "Enlarged ovaries, multiple small follicular cysts (necklace pattern), thick capsule, prominent stroma"),
    ("Labs:", "↑LH:FSH (>2), ↑androgens, ↑insulin, ↑AMH; USG: >12 follicles/ovary"),
    ("Risks:", "Type 2 DM, endometrial carcinoma (unopposed estrogen), CVD"),
])

card(s, Inches(9.0), Inches(0.6), Inches(4.15), Inches(6.5), "OVARIAN TUMORS", [
    ("SURFACE EPITHELIAL (MC, 65%):", ""),
    ("Serous cystadenoma/CA:", "MC overall; psammoma bodies; bilateral; CA125 marker"),
    ("Mucinous:", "Pseudomyxoma peritonei (mucin in abdomen); large multilocular"),
    ("Endometrioid:", "Associated with endometriosis; looks like endometrial CA"),
    ("Brenner:", "Transitional cells; Walthard nests; mostly benign"),
    ("GERM CELL TUMORS (20%, young women):", ""),
    ("Mature teratoma:", "MC germ cell; hair, teeth, thyroid (struma ovarii); dermoid cyst"),
    ("Immature teratoma:", "Malignant; neural tissue; AFP ↑"),
    ("Dysgerminoma:", "Analogous to seminoma; LDH marker; radiosensitive; best prognosis"),
    ("Yolk sac tumor:", "MC malignant germ cell in children; Schiller-Duval bodies; AFP ↑↑"),
    ("Choriocarcinoma:", "β-hCG ↑↑; follows molar pregnancy"),
    ("SEX CORD-STROMAL (5%):", ""),
    ("Granulosa cell:", "Estrogen-producing → precocious puberty (children), PMB (adults); Call-Exner bodies; inhibin marker"),
    ("Thecoma:", "Estrogen-producing; benign; postmenopausal"),
    ("Sertoli-Leydig:", "Androgen-producing → virilization"),
    ("STAGING:", "FIGO staging; Stage I = confined to ovaries"),
    ("SCREENING:", "CA125 + USG (not reliable for general screening)"),
], font_size=7.5)

# ══════════════════════════════════════════════════════════════════
# SLIDE 10 – NEOPLASIA + DIABETES + CEREBROVASCULAR
# ══════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
slide_header(s, "NEOPLASIA  |  Benign vs Malignant  |  Diabetes  |  Cerebrovascular", "5M + 10M Topics")

card(s, Inches(0.15), Inches(0.6), Inches(5.5), Inches(6.5), "NEOPLASIA — DEFINE, CLASSIFY, BENIGN vs MALIGNANT", [
    ("DEFINITION:", "Abnormal, uncontrolled, purposeless proliferation of cells that persists after removal of stimulus (Willis)"),
    ("CLASSIFICATION:", ""),
    ("By tissue:", "Epithelial (carcinoma), Mesenchymal (sarcoma), Mixed, Germ cell, Haematolymphoid"),
    ("By behavior:", "Benign, Malignant, Borderline"),
    ("BENIGN vs MALIGNANT:", ""),
    ("",                  "BENIGN                    MALIGNANT"),
    ("Differentiation:",  "Well diff                 Poorly diff/anaplastic"),
    ("Growth rate:",      "Slow                      Rapid; ↑mitoses"),
    ("Growth pattern:",   "Expansile; encapsulated   Infiltrative; no capsule"),
    ("Mitoses:",          "Rare; normal              Frequent; atypical"),
    ("Necrosis:",         "Absent                    Common (↑growth > supply)"),
    ("Metastasis:",       "NEVER (key criterion)     YES (defines malignancy)"),
    ("Recurrence:",       "Rare after excision        Common"),
    ("Effect:",           "Local pressure            Local + systemic"),
    ("Capsule:",          "Present                   Absent"),
    ("Nuclei:",           "Normal N:C ratio          ↑N:C; hyperchromatism; prominent nucleoli"),
    ("Exceptions:",       "Hemangioma — no capsule but benign; Leiomyoma (fibroid) — benign but no true capsule"),
    ("GRADING:",          "Degree of differentiation (I-IV); based on histology"),
    ("STAGING (TNM):",    "T=tumor size; N=node; M=metastasis; FIGO for gynae; Ann Arbor for lymphoma"),
    ("CARCINOGENESIS:", "Initiation (mutagen) → Promotion (proliferation) → Progression (invasion/mets)"),
    ("Oncogenes:",     "Proto-oncogene → point mutation/amplification/translocation → oncogene (dominant gain of fn)"),
    ("Tumor suppressor:", "Rb (retinoblastoma), p53 (guardian of genome), APC (colon Ca); recessive (2-hit hypothesis)"),
], font_size=7.5)

card(s, Inches(5.8), Inches(0.6), Inches(3.5), Inches(3.2), "TYPE I DIABETES MELLITUS", [
    ("Type:", "Autoimmune destruction of β cells (islets of Langerhans)"),
    ("HLA:", "HLA-DR3 and HLA-DR4 (strongest association)"),
    ("Antibodies:", "Anti-GAD, anti-islet cell, anti-insulin"),
    ("Onset:", "Young (childhood/adolescence); lean; sudden onset"),
    ("C-peptide:", "Low/absent (no endogenous insulin)"),
    ("Ketoacidosis:", "Prone to DKA (no insulin → FFA → ketones)"),
    ("Histology:", "Lymphocytic insulitis early; β cell loss; amyloid not seen (cf. Type II)"),
    ("Complications:", "Microangiopathy (retinopathy, nephropathy, neuropathy), macrovascular (CAD, stroke, PVD)"),
    ("Treat:", "Insulin (mandatory); no insulin = death"),
])

card(s, Inches(5.8), Inches(3.95), Inches(3.5), Inches(3.15), "CEREBRAL INFARCTION + CVD", [
    ("ISCHEMIC STROKE (80%):", "Thrombosis (in-situ) or Embolism; MC territory: MCA"),
    ("Pathology:", "Liquefactive necrosis (brain); pale/soft → cystic cavity"),
    ("HEMORRHAGIC (20%):", "ICH (hypertensive — lenticulostriate aa.) or SAH (Berry aneurysm, AVM)"),
    ("TIA:", "< 24h resolution; same symptoms; same causes"),
    ("MCA stroke:", "Contralateral hemiplegia (face + arm > leg), hemianopia, aphasia (dominant)"),
    ("CVD causes:", "HTN (#1), atherosclerosis, embolism (AF, MI), coagulopathy, vasculitis"),
    ("Lab:", "CT (hemorrhage = white acutely); MRI (DWI — ischemia within hours)"),
    ("Treat ischemic:", "IV tPA within 4.5h; thrombectomy within 24h (large vessel)"),
])

card(s, Inches(9.45), Inches(0.6), Inches(3.7), Inches(6.5), "RETINOBLASTOMA + OSTEOMYELITIS + RHEUMATIC HEART", [
    ("RETINOBLASTOMA:", ""),
    ("Gene:", "RB1 (chromosome 13q14) — tumor suppressor; 2-hit hypothesis (Knudson)"),
    ("Presentation:", "Leukocoria (white pupillary reflex MC), strabismus, ↓vision"),
    ("Age:", "Children < 5 yrs; bilateral = hereditary (germline); unilateral often sporadic"),
    ("Histology:", "Flexner-Wintersteiner rosettes (photoreceptor diff); Homer-Wright rosettes (generic neuroblastic)"),
    ("Treatment:", "Enucleation (large), chemo + radiotherapy"),
    ("RHEUMATIC HEART DISEASE:", ""),
    ("Cause:", "Group A Strep throat → cross-reactive antibodies (molecular mimicry) → carditis"),
    ("Jones criteria:", "Major: carditis, polyarthritis, chorea, erythema marginatum, subcutaneous nodules"),
    ("Pathology:", "Aschoff bodies (pathognomonic) = granuloma with Anitschkow cells (caterpillar cells)"),
    ("Valves affected:", "Mitral MC (mitral stenosis), then aortic; tricuspid & pulmonary rare"),
    ("Mitral stenosis:", "Fish-mouth valve; left atrial enlargement; AF; dysphagia; hemoptysis"),
    ("Prevent:", "Penicillin prophylaxis after strep throat"),
    ("THROMBOSIS (recap):", ""),
    ("Virchow's triad:", "Injury + Stasis + Hypercoagulability"),
    ("DVT complication:", "Pulmonary embolism (sudden death, Hampton's hump on CXR)"),
], font_size=7.5)

# ══════════════════════════════════════════════════════════════════
# SLIDE 11 – RAPID REVIEW: HIGH-YIELD BUZZWORDS & ONE-LINERS
# ══════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
slide_header(s, "RAPID REVIEW  |  High-Yield Buzzwords & One-Liners", "Last-Minute Revision")

col1 = [
    ("Psammoma bodies →", "Serous cystadenoma, meningioma, papillary thyroid Ca, mesothelioma"),
    ("Schiller-Duval bodies →", "Yolk sac tumor (AFP↑)"),
    ("Call-Exner bodies →", "Granulosa cell tumor (inhibin↑)"),
    ("Flexner-Wintersteiner →", "Retinoblastoma"),
    ("Aschoff bodies →", "Rheumatic fever (carditis)"),
    ("Mallory hyaline →", "Alcoholic hepatitis"),
    ("Kimmelstiel-Wilson →", "Diabetic nephropathy"),
    ("Councilman bodies →", "Yellow fever (hepatocyte apoptosis)"),
    ("Curschmann spirals →", "Asthma (mucus casts)"),
    ("Charcot-Leyden crystals →", "Asthma (eosinophil breakdown)"),
    ("Virchow's node →", "Left supraclavicular LN; gastric carcinoma"),
    ("Krukenberg tumor →", "Gastric Ca mets to ovary; signet ring cells"),
    ("Linitis plastica →", "Diffuse gastric Ca; leather bottle stomach"),
    ("Leukocoria →", "Retinoblastoma (white pupil reflex)"),
]

col2 = [
    ("LAP score ↓ →", "CML (BCR-ABL, Philadelphia chromosome t(9;22))"),
    ("LAP score ↑ →", "Leukemoid reaction (infection/stress)"),
    ("Hypersegmented neutrophils →", "Megaloblastic anemia (≥5 lobes in >5%)"),
    ("Koilocytes →", "HPV infection (cervical Pap smear)"),
    ("Spike & dome →", "Membranous GN (EM: subepithelial deposits)"),
    ("Foot process fusion →", "Minimal Change Disease (EM only)"),
    ("Wire loop lesion →", "Lupus nephritis (SLE, MPGN type)"),
    ("Brodie abscess →", "Chronic osteomyelitis (walled-off cavity)"),
    ("Sequestrum →", "Dead bone in osteomyelitis"),
    ("Involucrum →", "Periosteal new bone in osteomyelitis"),
    ("Peau d'orange →", "Inflammatory breast Ca (lymphatic blockage)"),
    ("Indian file pattern →", "Invasive lobular carcinoma"),
    ("Ghost cells →", "Coagulative necrosis (cell outline preserved)"),
    ("Ghon complex →", "Primary TB (focus + lymph node)"),
]

col3 = [
    ("FENa < 1% →", "Pre-renal AKI"),
    ("FENa > 2% →", "Intrinsic renal (ATN)"),
    ("Muddy brown casts →", "ATN (acute tubular necrosis)"),
    ("Oval fat bodies →", "Nephrotic syndrome"),
    ("Troponin I/T →", "Most specific for MI; rises 4-6h"),
    ("CK-MB →", "Rises 4-8h; back to normal 48-72h (reinfarction marker)"),
    ("AST:ALT >2:1 →", "Alcoholic hepatitis"),
    ("Anti-HBs →", "Immunity (vaccination or recovery)"),
    ("HBeAg →", "Active viral replication/high infectivity"),
    ("BCR-ABL →", "CML; t(9;22) Philadelphia chromosome"),
    ("EBV →", "Burkitt lymphoma (c-MYC); Hodgkin; nasopharyngeal Ca; EBV-PTLD"),
    ("H. pylori →", "Gastric Ca + MALT lymphoma + peptic ulcer"),
    ("VHL mutation →", "Clear cell RCC (70% of RCC)"),
    ("WT1 mutation →", "Wilms tumor (nephroblastoma)"),
]

# Three columns
fill_bg(s)
# Add bg rect for section
add_rect(s, Inches(0.15), Inches(0.62), Inches(4.3), Inches(6.6), CARD_BG, DIVIDER, Pt(0.75))
add_rect(s, Inches(0.15), Inches(0.62), Inches(4.3), Inches(0.28), ACCENT1)
add_text(s, "PATHOLOGICAL BUZZWORDS — Column 1", Inches(0.2), Inches(0.63), Inches(4.2), Inches(0.26), 9, bold=True, color=WHITE)
add_multiline(s, col1, Inches(0.2), Inches(0.95), Inches(4.2), Inches(6.25), 8, color=LIGHT, label_color=ACCENT2)

add_rect(s, Inches(4.6), Inches(0.62), Inches(4.3), Inches(6.6), CARD_BG, DIVIDER, Pt(0.75))
add_rect(s, Inches(4.6), Inches(0.62), Inches(4.3), Inches(0.28), ACCENT1)
add_text(s, "PATHOLOGICAL BUZZWORDS — Column 2", Inches(4.65), Inches(0.63), Inches(4.2), Inches(0.26), 9, bold=True, color=WHITE)
add_multiline(s, col2, Inches(4.65), Inches(0.95), Inches(4.2), Inches(6.25), 8, color=LIGHT, label_color=ACCENT2)

add_rect(s, Inches(9.05), Inches(0.62), Inches(4.1), Inches(6.6), CARD_BG, DIVIDER, Pt(0.75))
add_rect(s, Inches(9.05), Inches(0.62), Inches(4.1), Inches(0.28), ACCENT1)
add_text(s, "LABS & MARKERS — Column 3", Inches(9.1), Inches(0.63), Inches(4.0), Inches(0.26), 9, bold=True, color=WHITE)
add_multiline(s, col3, Inches(9.1), Inches(0.95), Inches(4.0), Inches(6.25), 8, color=LIGHT, label_color=ACCENT2)

# ══════════════════════════════════════════════════════════════════
# SAVE
# ══════════════════════════════════════════════════════════════════
out = "/tmp/workspace/patho-cheatsheet/Pathology_CheatSheet.pptx"
buf = BytesIO()
prs.save(buf)
with open(out, "wb") as f:
    f.write(buf.getvalue())
print(f"Saved: {out}")

from pptx import Presentation
from pptx.util import Inches, Pt, Emu
from pptx.dml.color import RGBColor
from pptx.enum.text import PP_ALIGN, MSO_ANCHOR
from pptx.oxml.ns import qn
from pptx.util import Inches, Pt
from io import BytesIO
import lxml.etree as etree
import copy

# ─── PALETTE ────────────────────────────────────────────────────────────────
# Warm, pastel Pinterest study aesthetic
BG_CREAM   = RGBColor(0xFF, 0xF8, 0xF0)   # warm cream background
BG_BLUSH   = RGBColor(0xFF, 0xEE, 0xE8)   # soft blush
ROSE       = RGBColor(0xE8, 0x8C, 0x9A)   # muted rose (headings)
DUSTY_PINK = RGBColor(0xF2, 0xB5, 0xC0)   # dusty pink accent
LAVENDER   = RGBColor(0xC9, 0xB8, 0xE8)   # soft lavender
SAGE       = RGBColor(0xA8, 0xC5, 0xA0)   # sage green
PEACH      = RGBColor(0xF5, 0xC8, 0xA8)   # warm peach
SKY        = RGBColor(0xA8, 0xD4, 0xE8)   # soft sky blue
BUTTER     = RGBColor(0xF7, 0xE8, 0xA0)   # butter yellow
MAUVE      = RGBColor(0xD4, 0xA8, 0xB8)   # mauve

# Text colours
DARK_BROWN = RGBColor(0x4A, 0x2E, 0x2E)   # rich dark brown (main text)
MID_BROWN  = RGBColor(0x7A, 0x5C, 0x5C)   # medium brown
HEADING_DARK = RGBColor(0x8B, 0x3A, 0x4A) # deep rose for main headings
LABEL_COL  = RGBColor(0x7B, 0x4F, 0x7B)   # purple-ish for labels
WHITE      = RGBColor(0xFF, 0xFF, 0xFF)
SOFT_WHITE = RGBColor(0xFF, 0xFC, 0xFA)

# Card backgrounds (very soft tints)
CARD_ROSE    = RGBColor(0xFF, 0xF0, 0xF3)
CARD_LAVEN   = RGBColor(0xF5, 0xF0, 0xFF)
CARD_SAGE    = RGBColor(0xF0, 0xF8, 0xF0)
CARD_PEACH   = RGBColor(0xFF, 0xF5, 0xED)
CARD_SKY     = RGBColor(0xEE, 0xF7, 0xFF)
CARD_BUTTER  = RGBColor(0xFF, 0xFC, 0xEE)

W = Inches(13.333)
H = Inches(7.5)

prs = Presentation()
prs.slide_width  = W
prs.slide_height = H
blank = prs.slide_layouts[6]

# ─── HELPERS ─────────────────────────────────────────────────────────────────

def fill_bg(slide, color=BG_CREAM):
    bg = slide.background
    fill = bg.fill
    fill.solid()
    fill.fore_color.rgb = color

def add_rect(slide, x, y, w, h, fill_color, line_color=None, line_width=None, radius=False):
    shape = slide.shapes.add_shape(1, x, y, w, h)
    shape.fill.solid()
    shape.fill.fore_color.rgb = fill_color
    if line_color:
        shape.line.color.rgb = line_color
        if line_width:
            shape.line.width = line_width
    else:
        shape.line.fill.background()
    return shape

def add_rounded_rect(slide, x, y, w, h, fill_color, line_color=None, line_width=None):
    """Rounded rectangle using shape type 5 (MSO_SHAPE.ROUNDED_RECTANGLE)"""
    from pptx.enum.shapes import MSO_SHAPE_TYPE
    shape = slide.shapes.add_shape(5, x, y, w, h)   # 5 = rounded rectangle
    shape.fill.solid()
    shape.fill.fore_color.rgb = fill_color
    # set rounding
    shape.adjustments[0] = 0.05
    if line_color:
        shape.line.color.rgb = line_color
        if line_width:
            shape.line.width = line_width
    else:
        shape.line.fill.background()
    return shape

def add_text(slide, text, x, y, w, h, size, bold=False, color=DARK_BROWN,
             align=PP_ALIGN.LEFT, italic=False, font="Georgia"):
    tb = slide.shapes.add_textbox(x, y, w, h)
    tf = tb.text_frame
    tf.word_wrap = True
    tf.margin_left = Pt(3); tf.margin_right = Pt(3)
    tf.margin_top = Pt(1);  tf.margin_bottom = Pt(1)
    p = tf.paragraphs[0]
    p.alignment = align
    run = p.add_run()
    run.text = text
    run.font.size = Pt(size)
    run.font.bold = bold
    run.font.italic = italic
    run.font.color.rgb = color
    run.font.name = font
    return tb

def add_ml(slide, lines, x, y, w, h, size, body_color=DARK_BROWN,
           label_color=LABEL_COL, font="Calibri", line_spacing=1.1):
    tb = slide.shapes.add_textbox(x, y, w, h)
    tf = tb.text_frame
    tf.word_wrap = True
    tf.margin_left = Pt(4); tf.margin_right = Pt(4)
    tf.margin_top = Pt(2);  tf.margin_bottom = Pt(2)
    first = True
    for item in lines:
        p = tf.paragraphs[0] if first else tf.add_paragraph()
        first = False
        p.space_before = Pt(1.2)
        if isinstance(item, tuple):
            label, val = item
            if label:
                r1 = p.add_run()
                r1.text = label + " "
                r1.font.size = Pt(size)
                r1.font.bold = True
                r1.font.color.rgb = label_color
                r1.font.name = font
            if val:
                r2 = p.add_run()
                r2.text = val
                r2.font.size = Pt(size)
                r2.font.color.rgb = body_color
                r2.font.name = font
        else:
            run = p.add_run()
            run.text = item
            run.font.size = Pt(size)
            run.font.color.rgb = body_color
            run.font.name = font
    return tb

def card(slide, x, y, w, h, title, lines, card_bg=CARD_ROSE,
         title_bg=ROSE, title_fg=WHITE, font_size=8.2,
         icon="", label_color=LABEL_COL, body_color=DARK_BROWN):
    # Drop shadow (offset rect)
    shadow = add_rounded_rect(slide, x+Pt(3), y+Pt(3), w, h,
                               RGBColor(0xE0, 0xD0, 0xD0))
    shadow.fill.fore_color.rgb = RGBColor(0xE8, 0xDC, 0xDC)
    # Main card
    add_rounded_rect(slide, x, y, w, h, card_bg, RGBColor(0xE0, 0xCC, 0xCC), Pt(0.5))
    # Title bar (rounded top illusion: just a rect overlapping top of rounded rect)
    add_rect(slide, x, y, w, Inches(0.32), title_bg)
    # Re-draw rounded card on top of shadow to mask title bar edges
    # Title text
    title_str = (icon + "  " if icon else "") + title
    add_text(slide, title_str, x+Pt(6), y+Pt(2), w-Pt(12), Inches(0.3),
             9.5, bold=True, color=title_fg, font="Georgia")
    # Body
    add_ml(slide, lines, x+Pt(6), y+Inches(0.33), w-Pt(12),
           h-Inches(0.38), font_size, body_color=body_color,
           label_color=label_color)

def page_header(slide, title, subtitle="", bg_color=BG_BLUSH,
                accent=ROSE, sub_color=MID_BROWN):
    fill_bg(slide, bg_color)
    # Decorative top stripe
    add_rect(slide, 0, 0, W, Inches(0.08), accent)
    # Header band
    add_rect(slide, 0, Inches(0.08), W, Inches(0.56), BG_BLUSH)
    # Big title
    add_text(slide, title, Inches(0.35), Inches(0.06), Inches(9.5), Inches(0.54),
             20, bold=True, color=HEADING_DARK, font="Georgia")
    if subtitle:
        add_text(slide, subtitle, Inches(9.9), Inches(0.14), Inches(3.2), Inches(0.38),
                 10, italic=True, color=sub_color, align=PP_ALIGN.RIGHT, font="Calibri")
    # Thin divider line below header
    add_rect(slide, 0, Inches(0.64), W, Pt(1.5), DUSTY_PINK)

# Card colour cycling
CARD_CYCLE = [
    (CARD_ROSE,   ROSE,     "✿"),
    (CARD_LAVEN,  LAVENDER, "❋"),
    (CARD_SAGE,   SAGE,     "✦"),
    (CARD_PEACH,  PEACH,    "◈"),
    (CARD_SKY,    SKY,      "❀"),
    (CARD_BUTTER, BUTTER,   "✸"),
]
def cc(i):
    bg, hdr, ico = CARD_CYCLE[i % len(CARD_CYCLE)]
    hdr_text = RGBColor(0x4A, 0x2E, 0x2E) if hdr in (BUTTER, PEACH, SAGE, SKY, LAVENDER) else WHITE
    return bg, hdr, hdr_text, ico

# ══════════════════════════════════════════════════════════════════════════════
# SLIDE 1 — TITLE
# ══════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
fill_bg(s, BG_CREAM)

# Large decorative circles (Pinterest vibe)
for cx, cy, cr, col in [
    (Inches(0.0),  Inches(0.0),  Inches(2.5), RGBColor(0xF2,0xD4,0xDB)),
    (Inches(11.5), Inches(5.5),  Inches(2.8), RGBColor(0xD4,0xC8,0xE8)),
    (Inches(12.5), Inches(0.5),  Inches(1.8), RGBColor(0xC8,0xE8,0xD0)),
    (Inches(0.5),  Inches(6.0),  Inches(1.5), RGBColor(0xF5,0xD8,0xB0)),
]:
    c = s.shapes.add_shape(9, cx-cr/2, cy-cr/2, cr, cr)   # oval
    c.fill.solid(); c.fill.fore_color.rgb = col
    c.line.fill.background()

# Central white card
add_rounded_rect(s, Inches(2.5), Inches(1.2), Inches(8.3), Inches(5.0),
                 SOFT_WHITE, RGBColor(0xF0,0xCC,0xD4), Pt(1))

# Decorative top tag
add_rect(s, Inches(4.5), Inches(1.2), Inches(4.3), Inches(0.45), ROSE)
add_text(s, "✿  EXAM PREP NOTES  ✿", Inches(4.5), Inches(1.2), Inches(4.3), Inches(0.45),
         11, bold=True, color=WHITE, align=PP_ALIGN.CENTER, font="Georgia")

add_text(s, "Pathology", Inches(2.8), Inches(1.8), Inches(7.8), Inches(1.6),
         68, bold=True, color=HEADING_DARK, align=PP_ALIGN.CENTER, font="Georgia")
add_text(s, "High-Yield Cheat Sheet", Inches(2.8), Inches(3.3), Inches(7.8), Inches(0.7),
         24, bold=False, color=ROSE, align=PP_ALIGN.CENTER, font="Georgia")

add_rect(s, Inches(3.5), Inches(4.05), Inches(6.3), Pt(1.5), DUSTY_PINK)

add_text(s, "10-Mark & 5-Mark Topics  •  General + Systemic Pathology  •  Oncology  •  Genetics",
         Inches(2.8), Inches(4.15), Inches(7.8), Inches(0.45),
         11, italic=True, color=MID_BROWN, align=PP_ALIGN.CENTER, font="Calibri")
add_text(s, "Necrosis  •  Shock  •  Anemia  •  Nephrotic Syndrome  •  Carcinomas  •  Infections",
         Inches(2.8), Inches(4.65), Inches(7.8), Inches(0.38),
         10, color=MID_BROWN, align=PP_ALIGN.CENTER, font="Calibri")

# little hearts
add_text(s, "♡  study smart, not just hard  ♡", Inches(2.8), Inches(5.2), Inches(7.8), Inches(0.4),
         10, italic=True, color=DUSTY_PINK, align=PP_ALIGN.CENTER, font="Georgia")

# ══════════════════════════════════════════════════════════════════════════════
# SLIDE 2 — CELL INJURY: NECROSIS + METAPLASIA + EDEMA + INFLAMMATION
# ══════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
page_header(s, "✿  Cell Injury  •  Necrosis  •  Edema  •  Inflammation", "5-Mark Topics", BG_CREAM, ROSE)

bg, hdr, hdr_fg, ico = cc(0)
card(s, Inches(0.15), Inches(0.72), Inches(3.2), Inches(3.5), "Types of Necrosis", [
    ("🔴 Coagulative:", "Ischemia; ghost cell outline; MI, renal infarct"),
    ("💧 Liquefactive:", "Brain infarct & abscess; enzymes dissolve tissue"),
    ("🧀 Caseous:", "TB; cheese-like; granuloma + Langhans cells"),
    ("🫙 Fat:", "Pancreatitis; saponification; chalky deposits"),
    ("🔬 Fibrinoid:", "Immune vasculitis, malignant HTN; pink homogeneous"),
    ("🦵 Gangrenous:", "Dry = coagulative; Wet = + infection/liquefactive"),
], card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico, font_size=8.2)

bg, hdr, hdr_fg, ico = cc(1)
card(s, Inches(0.15), Inches(4.32), Inches(3.2), Inches(2.9), "Metaplasia", [
    ("Definition:", "Reversible replacement of one mature cell type by another"),
    ("Squamous:", "Respiratory (smokers), cervix, bladder (reversible)"),
    ("Intestinal:", "Barrett esophagus (GERD → goblet cells); stomach (H. pylori)"),
    ("Key:", "Caused by chronic irritation; pre-cursor to dysplasia if persistent"),
], card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(2)
card(s, Inches(3.5), Inches(0.72), Inches(3.3), Inches(3.1), "Edema — Mechanisms", [
    ("⬆ Hydrostatic P:", "CHF, venous obstruction → push fluid out"),
    ("⬇ Oncotic P:", "↓Albumin: nephrotic syn., liver failure, malnutrition"),
    ("⬆ Vascular perm:", "Inflammation, burns → protein-rich exudate"),
    ("🚫 Lymph obstruct:", "Filariasis (elephantiasis), post-mastectomy"),
    ("🧂 Na+ retention:", "Renal failure, hyperaldosteronism"),
    ("Pitting:", "Cardiac/renal edema → pitting on pressure"),
    ("Non-pitting:", "Lymphedema, myxedema → no pitting"),
], card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(3)
card(s, Inches(3.5), Inches(3.92), Inches(3.3), Inches(3.28), "Transudate vs Exudate", [
    ("",            "TRANSUDATE      EXUDATE"),
    ("Protein:",    "< 3 g/dL        > 3 g/dL"),
    ("LDH:",        "Low             High"),
    ("Look:",       "Clear           Cloudy/turbid"),
    ("Cells:",      "Few             Many PMNs"),
    ("Cause:",      "CHF, cirrhosis, Infection,"),
    ("",            "nephrotic syn.  inflammation"),
    ("Gravity:",    "< 1.012         > 1.020"),
], card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico, font_size=8)

bg, hdr, hdr_fg, ico = cc(4)
card(s, Inches(6.95), Inches(0.72), Inches(6.2), Inches(6.5), "Inflammation — Vascular & Cellular Events", [
    ("🌊 VASCULAR EVENTS:", ""),
    ("1️⃣", "Transient vasoconstriction (seconds)"),
    ("2️⃣", "Vasodilation: histamine + NO → ↑blood flow (redness, heat)"),
    ("3️⃣", "↑Vascular permeability → protein-rich exudate → swelling"),
    ("4️⃣", "Stasis → margination of neutrophils"),
    ("🔬 CELLULAR EVENTS:", ""),
    ("5️⃣", "Rolling: P-selectin & E-selectin on endothelium"),
    ("6️⃣", "Adhesion: ICAM-1 + LFA-1/Mac-1 (integrins)"),
    ("7️⃣", "Diapedesis: through vessel wall via PECAM-1/CD31"),
    ("8️⃣", "Chemotaxis: C5a, IL-8, LTB4, fMLP (bacterial)"),
    ("9️⃣", "Phagocytosis → Killing: ROS, MPO, defensins, NO"),
    ("💊 CHEMICAL MEDIATORS:", ""),
    ("Vasoactive:", "Histamine (mast cells), serotonin, bradykinin"),
    ("Prostaglandins:", "PGE2 (fever/pain), PGI2 (vasodilation)"),
    ("Leukotrienes:", "LTB4 (chemotaxis), LTC4/D4/E4 (bronchospasm)"),
    ("Complement:", "C3a + C5a (anaphylatoxins), C5b-9 (MAC lysis)"),
    ("Cytokines:", "IL-1, TNF (fever, acute phase), IL-6, IL-8"),
    ("🌿 CHRONIC inflammation:", "Lymphocytes, macrophages, plasma cells; granulomas"),
], card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico, font_size=8)

# ══════════════════════════════════════════════════════════════════════════════
# SLIDE 3 — SHOCK + THROMBOSIS + MI
# ══════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
page_header(s, "❋  Shock  •  Thrombosis  •  Infarction  •  MI", "5M + 10M Topics", BG_CREAM, LAVENDER)

bg, hdr, hdr_fg, ico = cc(1)
card(s, Inches(0.15), Inches(0.72), Inches(4.1), Inches(6.5), "Shock — Types & Pathogenesis", [
    ("💔 HYPOVOLEMIC:", "↓Blood vol (haemorrhage, burns, dehydration); ↓CO, ↑SVR; skin cold + pale"),
    ("❤️ CARDIOGENIC:", "↓Pump fn (MI, arrhythmia, tamponade); ↓CO, ↑SVR; JVP↑"),
    ("🌡 DISTRIBUTIVE:", "Vasodilation → ↓SVR; warm shock"),
    ("  Septic:", "Gram -ve LPS → TNF/IL-1 → NO → massive vasodilation"),
    ("  Anaphylactic:", "IgE → mast cells → histamine; urticaria + bronchospasm"),
    ("  Neurogenic:", "Loss of vasomotor tone (spinal injury)"),
    ("🫁 OBSTRUCTIVE:", "PE, tension pneumothorax → ↑afterload → ↓CO"),
    ("📊 STAGES:", ""),
    ("Stage 1 — Compensated:", "↑HR, ↑SVR; BP maintained by baroreceptors"),
    ("Stage 2 — Progressive:", "Lactic acidosis; ↓urine output; AMS"),
    ("Stage 3 — Irreversible:", "MOF, DIC, death; irreversible cell injury"),
    ("🫀 End-organ effects:", ""),
    ("Kidney:", "ATN (oliguria → acute renal failure) — MC cause ATN"),
    ("Lung:", "ARDS (diffuse alveolar damage, hyaline membranes)"),
    ("Liver:", "Centrilobular necrosis (zone 3, farthest from artery)"),
    ("Brain:", "Watershed infarcts (border zone ischemia)"),
    ("GI:", "Mucosal ischemia → bacterial translocation → sepsis"),
], font_size=7.8, card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(4)
card(s, Inches(4.4), Inches(0.72), Inches(3.6), Inches(3.05), "Thrombosis — Virchow's Triad", [
    ("1️⃣ Endothelial injury:", "Atherosclerosis, trauma, hypertension, smoking"),
    ("2️⃣ Stasis:", "Immobility, CHF, varicose veins, atrial fibrillation"),
    ("3️⃣ Hypercoagulability:", "Factor V Leiden (MC), OCP, malignancy, antiphospholipid syndrome"),
    ("Fate of thrombus:", "Resolution ✓ → Organization → Recanalization → Embolism → Calcification (phlebolith)"),
    ("DVT risk:", "Femoral/popliteal vein; Homan's sign ± (unreliable); → PE"),
], card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(2)
card(s, Inches(4.4), Inches(3.87), Inches(3.6), Inches(3.35), "Infarction — Types + Examples", [
    ("⚪ WHITE (Anemic):", "Solid organs — heart, kidney, spleen; arterial occlusion; coagulative necrosis; sharp margins"),
    ("🔴 RED (Hemorrhagic):", "Loose/spongy tissue — lung, intestine; venous occlusion or dual supply; reperfusion"),
    ("Lung:", "Red; wedge-shaped; base on pleura; >60% from DVT"),
    ("Renal:", "White; wedge; coagulative necrosis; flank pain + haematuria"),
    ("Brain:", "Liquefactive necrosis (pale or haemorrhagic)"),
    ("Intestine:", "Red; venous; → peritonitis, sepsis"),
], card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(0)
card(s, Inches(8.15), Inches(0.72), Inches(5.0), Inches(6.5), "Myocardial Infarction + Atherosclerosis", [
    ("🧈 ATHEROSCLEROSIS:", ""),
    ("Pathogenesis:", "Endothelial injury → LDL accumulation → oxidized LDL → monocytes → foam cells → fatty streak → fibrous plaque → rupture → thrombus"),
    ("Risk factors:", "HTN, DM, smoking, dyslipidemia, obesity, FH, age, male sex"),
    ("❤️‍🔥 MYOCARDIAL INFARCTION:", ""),
    ("MC vessel:", "LAD (40%) → anterior wall; RCA (30%) → inferior; LCx (20%) → lateral"),
    ("0 – 4h:", "No gross change; coagulative necrosis begins; wavy fibres on EM"),
    ("4 – 12h:", "Hypereosinophilic fibres; nuclear pyknosis; no gross change"),
    ("12 – 24h:", "Pale yellow/soft area; PMN infiltration begins"),
    ("1 – 3 days:", "Pallor + neutrophil infiltration peak"),
    ("3 – 7 days:", "Macrophages clean up; yellow-white softening; RUPTURE RISK ↑↑"),
    ("1 – 3 wks:", "Granulation tissue (pink vascular); still soft → rupture risk"),
    ("Months:", "Dense collagen scar; grey-white; no contraction"),
    ("🧪 ENZYMES:", ""),
    ("Troponin I/T:", "Most specific ✓; rises 4-6h, peaks 24h, stays ↑ 7-10d"),
    ("CK-MB:", "Rises 4-8h, peaks 24h, normal in 48-72h (use for reinfarction)"),
    ("LDH:", "Rises 12-24h, peaks 3-6d (historical)"),
    ("⚠️ COMPLICATIONS:", "Arrhythmia (MC cause death), cardiogenic shock, free wall rupture (3-7d), papillary rupture (MR), VSR, mural thrombus, pericarditis (day 2-3), Dressler syndrome (wks later), ventricular aneurysm"),
], font_size=7.5, card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

# ══════════════════════════════════════════════════════════════════════════════
# SLIDE 4 — WOUND HEALING + GENETICS + HAEMOPHILIA
# ══════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
page_header(s, "✦  Wound Healing  •  Down  •  Turner  •  Haemophilia", "5-Mark Topics", BG_CREAM, SAGE)

bg, hdr, hdr_fg, ico = cc(2)
card(s, Inches(0.15), Inches(0.72), Inches(3.6), Inches(3.55), "Wound Healing — Phases", [
    ("🩹 PRIMARY INTENTION:", "Clean sutured wound; minimal scar"),
    ("Day 0-3:", "Haemostasis (platelet plug, clot) → Inflammation (PMNs day 1-2, macrophages day 2-3)"),
    ("Day 3-5:", "Proliferation: fibroblasts + angiogenesis (VEGF) + re-epithelialization (EGF)"),
    ("Day 5-7:", "Granulation tissue forms; Collagen III deposited (pink, fragile)"),
    ("Weeks:", "Remodeling: Collagen III → Collagen I (type I = strength); ↑tensile strength"),
    ("3 months:", "Max tensile strength = ~80% of original (never 100%)"),
    ("🔄 SECONDARY:", "Open wound; healing by contraction + granulation; larger scar; longer time"),
], card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(3)
card(s, Inches(0.15), Inches(4.37), Inches(3.6), Inches(2.85), "Factors Affecting Wound Healing", [
    ("🔴 LOCAL (impair):", "Infection (#1 local factor), foreign body, poor vascularity, radiation, wound size/tension"),
    ("🟡 SYSTEMIC (impair):", "DM (↓neutrophil fn, ↓collagen, neuropathy), malnutrition (↓collagen synthesis), steroids (↓inflammation), age, Vit C deficiency (↓collagen hydroxylation), Zinc deficiency"),
    ("Growth factors:", "EGF, PDGF, TGF-β (fibrosis), VEGF (angiogenesis), FGF"),
    ("⚡ Complications:", "Keloid (beyond wound margins, ↑in dark skin), hypertrophic scar (within margins), dehiscence, incisional hernia, contracture"),
], card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(0)
card(s, Inches(3.9), Inches(0.72), Inches(3.6), Inches(3.2), "Down Syndrome — Trisomy 21", [
    ("Genetics:", "Trisomy 21 (non-disjunction 95%); Robertsonian translocation t(14;21) 4%; Mosaic 1%"),
    ("Maternal age:", "Non-disjunction risk ↑ with advancing maternal age (>35 yrs)"),
    ("✨ Features:", "Flat face, upslanting palpebral fissures, epicanthal folds, flat nasal bridge, single palmar crease, clinodactyly, hypotonia, intellectual disability"),
    ("Cardiac:", "AVSD / VSD / ASD (40-50% of cases) — MC cause of death"),
    ("Cancer risk:", "↑AML (esp. AMKL in neonates), ↑ALL in children"),
    ("Alzheimer:", "↑Risk — APP gene on chr 21 → ↑amyloid"),
    ("Screening:", "Nuchal translucency; Triple test: ↓AFP, ↑hCG, ↓estriol"),
], card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(4)
card(s, Inches(3.9), Inches(4.02), Inches(3.6), Inches(3.2), "Turner Syndrome — 45,X", [
    ("Genetics:", "45,X monosomy (MC); mosaicism 45X/46XX (milder)"),
    ("Only:", "Females; loss of one X chromosome"),
    ("✨ Features:", "Short stature, webbed neck (pterygium colli), low posterior hairline, shield chest, wide-spaced nipples, cubitus valgus, lymphedema at birth"),
    ("Gonads:", "Streak gonads → 1° amenorrhea → infertility"),
    ("Hormones:", "↑FSH, ↑LH (hypergonadotropic hypogonadism); ↓estrogen"),
    ("Heart:", "Bicuspid aortic valve (MC cardiac defect); coarctation of aorta"),
    ("Treatment:", "GH for height; estrogen replacement for puberty"),
], card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(5)
card(s, Inches(7.65), Inches(0.72), Inches(5.5), Inches(6.5), "Haemophilia A & B", [
    ("🩸 HAEMOPHILIA A:", "Factor VIII deficiency; X-linked recessive"),
    ("🩸 HAEMOPHILIA B:", "Factor IX deficiency (Christmas disease); X-linked recessive"),
    ("Inheritance:", "Males affected (XY); females are carriers (XX); 50% sons affected"),
    ("Severity:", "Severe <1% factor; Moderate 1-5%; Mild 5-40%"),
    ("🧪 Lab findings:", ""),
    ("PTT:", "↑ (prolonged) — intrinsic pathway defect"),
    ("PT:", "Normal — extrinsic pathway intact"),
    ("BT:", "Normal — platelets and vWF normal"),
    ("Platelet count:", "Normal"),
    ("Factor assay:", "Low Factor VIII (A) or IX (B) — confirms diagnosis"),
    ("🔍 Clinical features:", ""),
    ("Hemarthrosis:", "Joints — knee (MC), elbow, ankle → chronic arthropathy"),
    ("Deep bleeds:", "Muscle haematomas, psoas haematoma"),
    ("Danger:", "Intracranial bleed; post-surgical/dental bleeding"),
    ("💊 Treatment:", ""),
    ("Haem A:", "Recombinant Factor VIII; DDAVP (mild cases — ↑endogenous FVIII)"),
    ("Haem B:", "Recombinant Factor IX"),
    ("Complication:", "Inhibitors (anti-FVIII IgG) in 30% on treatment → use bypassing agents"),
    ("vs vWD:", "vWD = ↑BT + ↑PTT; affects platelet adhesion (vWF bridges GpIb-collagen)"),
], font_size=7.8, card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

# ══════════════════════════════════════════════════════════════════════════════
# SLIDE 5 — HEMATOLOGY: ANEMIA
# ══════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
page_header(s, "◈  Hematology  •  IDA  •  Megaloblastic  •  Transfusion  •  CML", "10M + 5M Topics", BG_CREAM, PEACH)

bg, hdr, hdr_fg, ico = cc(3)
card(s, Inches(0.15), Inches(0.72), Inches(4.2), Inches(6.5), "Iron Deficiency Anemia (IDA)", [
    ("CAUSES:", ""),
    ("Blood loss:", "Menorrhagia (women, MC); GI bleed (men/elderly — always investigate)"),
    ("↓ Intake:", "Poor diet, exclusive breastfeeding, vegetarians"),
    ("↓ Absorption:", "Celiac disease, post-gastrectomy, achlorhydria"),
    ("↑ Demand:", "Pregnancy, infancy, growth spurts"),
    ("📊 STAGES:", ""),
    ("1 — Iron depletion:", "↓Ferritin; Hb normal; no anaemia yet"),
    ("2 — IDE:", "↓Serum iron, ↑TIBC; Hb still normal"),
    ("3 — IDA:", "↓Hb, ↓MCV, ↓MCH; microcytic hypochromic anaemia"),
    ("🧪 LAB FINDINGS:", ""),
    ("CBC:", "↓Hb, ↓MCV (<80 fL), ↓MCH, ↑RDW (anisocytosis)"),
    ("Iron studies:", "↓Serum iron, ↓Ferritin (best early marker), ↑TIBC, ↓Transferrin saturation (<15%)"),
    ("Blood smear:", "Microcytes, hypochromia, target cells, pencil cells, poikilocytosis"),
    ("BM:", "Absent iron stores (Prussian blue –ve)"),
    ("🙍 Symptoms:", "Fatigue, pallor, exertional dyspnoea, palpitations"),
    ("Signs:", "Koilonychia (spoon nails), glossitis, angular stomatitis, atrophic gastritis, pica (pagophagia), Plummer-Vinson syndrome (dysphagia)"),
    ("💊 Treatment:", "Oral ferrous sulfate; IV iron if malabsorption; treat underlying cause first"),
], font_size=7.8, card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(1)
card(s, Inches(4.5), Inches(0.72), Inches(4.4), Inches(6.5), "Megaloblastic Anemia (B12 & Folate)", [
    ("Mechanism:", "B12 or folate deficiency → impaired DNA synthesis → large, abnormal cells (megaloblasts)"),
    ("B12 CAUSES:", ""),
    ("Pernicious anaemia:", "Anti-intrinsic factor antibodies (MC); Schilling test +ve"),
    ("Others:", "Gastrectomy (↓IF), terminal ileal disease (Crohn's), strict vegan diet, fish tapeworm (Diphyllobothrium)"),
    ("FOLATE CAUSES:", ""),
    ("↓Intake:", "Poor diet (leafy veg), alcoholism (MC folate cause)"),
    ("↑Demand:", "Pregnancy (supplement prophylactically)"),
    ("Drugs:", "Methotrexate, trimethoprim, phenytoin (inhibit DHFR or absorption)"),
    ("⚡ B12 vs FOLATE key diff:", "B12 deficiency → NEUROLOGICAL: subacute combined degeneration (posterior columns + lateral corticospinal tracts) → paraesthesia, weakness, loss of vibration + proprioception; FOLATE = no neuro"),
    ("🧪 LAB FINDINGS:", ""),
    ("CBC:", "↑MCV (>100 fL), ↑MCH; pancytopenia (↓WBC, ↓platelets)"),
    ("Smear:", "Macro-ovalocytes ✓; hypersegmented neutrophils (≥5 lobes, >5%) ✓"),
    ("B12 specific:", "↑Methylmalonic acid (MMA) — most specific for B12 def; ↑homocysteine"),
    ("Folate specific:", "↑Homocysteine; normal MMA"),
    ("Serum:", "↓B12 or ↓folate; ↑LDH + ↑bilirubin (ineffective erythropoiesis)"),
    ("BM:", "Hypercellular; megaloblasts (large, open chromatin); giant metamyelocytes"),
    ("💊 Treatment:", "IM hydroxocobalamin (B12 deficiency or neurological); oral folic acid (folate); always rule out B12 first to avoid masking neuropathy with folate"),
], font_size=7.8, card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(4)
card(s, Inches(9.05), Inches(0.72), Inches(4.1), Inches(3.1), "Transfusion Reactions", [
    ("🔴 Acute Hemolytic:", "ABO mismatch → IgM → complement → intravascular haemolysis; fever + back pain + haemoglobinuria + DIC → STOP immediately"),
    ("🌡 Febrile (FNHTR):", "Anti-HLA Ab vs donor WBCs; fever + chills; MC reaction; no haemolysis; treat with antipyretics"),
    ("😤 Allergic:", "IgE vs donor plasma proteins; urticaria → anaphylaxis (IgA-deficient patient)"),
    ("🫁 TRALI:", "Anti-HLA in donor plasma → ARDS within 6h; leading cause of transfusion death"),
    ("💧 TACO:", "Circulatory overload; pulmonary oedema; treat with diuretics"),
    ("⏱ Delayed:", "3-10 days; extravascular; anti-Kidd/Duffy antibodies; unexplained ↓Hb"),
], card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico, font_size=8)

bg, hdr, hdr_fg, ico = cc(5)
card(s, Inches(9.05), Inches(3.95), Inches(4.1), Inches(3.27), "CML vs Leukemoid Reaction", [
    ("",             "LEUKEMOID RXN    CML"),
    ("WBC:",         "↑↑ >50,000       ↑↑↑ >100,000"),
    ("LAP score:",   "⬆ HIGH           ⬇ LOW ← KEY"),
    ("Ph chr:",      "Absent           t(9;22) BCR-ABL"),
    ("Basophilia:",  "Absent           Present ✓"),
    ("Blasts:",      "Absent           Present"),
    ("Spleen:",      "Mild             Massive"),
    ("Cause:",       "Infection/stress Myeloproliferative"),
    ("Treat:",       "Treat cause      Imatinib (TKI)"),
], card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico, font_size=8)

# ══════════════════════════════════════════════════════════════════════════════
# SLIDE 6 — RENAL
# ══════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
page_header(s, "❀  Renal Pathology  •  Nephrotic Syndrome  •  Renal Failure  •  Tumors", "10M + 5M", BG_CREAM, SKY)

bg, hdr, hdr_fg, ico = cc(4)
card(s, Inches(0.15), Inches(0.72), Inches(4.2), Inches(6.5), "Nephrotic Syndrome", [
    ("DEFINITION:", "Proteinuria >3.5 g/day + hypoalbuminaemia + oedema + hyperlipidaemia + lipiduria"),
    ("PRIMARY CAUSES:", ""),
    ("MCD:", "Minimal Change Disease; MC in children; responds to steroids; LM normal; EM: foot process fusion"),
    ("FSGS:", "Focal Segmental GS; MC in adults/HIV/heroin; poor prognosis; IgM deposits"),
    ("Membranous GN:", "MC in adults; spike & dome (silver stain); subepithelial deposits; PLA2R Ab"),
    ("MPGN:", "Tram-track (GBM splitting); C3 ↓↓; LM: mesangial proliferation"),
    ("SECONDARY CAUSES:", ""),
    ("DM:", "Kimmelstiel-Wilson nodules (pathognomonic); nodular glomerulosclerosis"),
    ("SLE:", "Wire loop lesion; MPGN pattern; anti-dsDNA"),
    ("Amyloidosis:", "Amyloid deposits; Congo red stain; apple-green birefringence"),
    ("Drugs:", "NSAIDs, gold, penicillamine, captopril"),
    ("🧪 INVESTIGATIONS:", ""),
    ("Urine 24h:", ">3.5 g protein/day; lipiduria (oval fat bodies, fatty casts)"),
    ("Blood:", "↓Albumin, ↑cholesterol, ↑TG, ↑LDL (↑apolipoprotein B)"),
    ("Renal biopsy:", "Gold standard for classification + treatment decisions"),
    ("COMPLICATIONS:", "Infection (↓IgG, ↓complement), thrombosis (↓antithrombin III → renal vein thrombosis), hyperlipidaemia → CVD"),
], font_size=7.5, card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(2)
card(s, Inches(4.5), Inches(0.72), Inches(4.0), Inches(3.2), "Renal Failure (AKI)", [
    ("PRE-RENAL:", "↓Perfusion; BUN:Cr >20; ↑urine osm; urine Na <20; FENa <1% → responds to fluids"),
    ("INTRINSIC:", "ATN (MC: ischemia or nephrotoxins); BUN:Cr ~10-15; urine Na >40; FENa >2%; muddy brown granular casts"),
    ("POST-RENAL:", "Obstruction (BPH, stone, tumor); BUN:Cr initially >20; hydronephrosis on US"),
    ("ATN stages:", "Oliguric (1-3 wks) → Diuretic (fluid + electrolyte loss) → Recovery"),
    ("CRF features:", "Uremia, ↑K+, metabolic acidosis, ↓EPO (anaemia), ↓Vit D → ↑PTH → renal osteodystrophy"),
], card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(0)
card(s, Inches(4.5), Inches(4.02), Inches(4.0), Inches(3.2), "Renal Tumors", [
    ("👶 WILMS TUMOR:", "Age 2-5 yrs; WT1 gene (chr 11); Triphasic: blastemal+stromal+epithelial; presents: abdominal mass + haematuria + HTN; excellent prognosis"),
    ("🔵 RCC — CLEAR CELL (75%):", "VHL mutation; yellow cut surface (lipid-rich); hematuria + flank pain + mass (late triad)"),
    ("Papillary RCC:", "Trisomy 7,17; foamy macrophages; hereditary (MET mutation)"),
    ("Chromophobe:", "KIT mutation; best prognosis among RCC subtypes"),
    ("Paraneoplastic:", "EPO (polycythemia), PTHrP (hypercalcemia), Renin (HTN), ACTH"),
    ("Spread:", "Renal vein → IVC (tumor thrombus); mets: lung + bone + adrenal"),
], card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(5)
card(s, Inches(8.65), Inches(0.72), Inches(4.5), Inches(6.5), "Rickets • Osteoporosis • Osteomyelitis", [
    ("🌱 RICKETS (Vit D deficiency):", ""),
    ("Features:", "Bow legs (genu varum), rachitic rosary (costochondral junctions), craniotabes, Harrison's sulcus, pigeon chest, delayed fontanelle"),
    ("Labs:", "↓Ca, ↓PO4, ↑ALP (↑↑), ↑PTH; X-ray: cupping + fraying of metaphysis"),
    ("Causes:", "↓Sun, ↓dietary Vit D, malabsorption, CKD (↓1α-hydroxylase)"),
    ("Osteomalacia:", "Same cause in adults; looser zones (pseudofractures) on X-ray"),
    ("🦴 OSTEOPOROSIS:", ""),
    ("Type I (Postmenopausal):", "↓Estrogen → ↑osteoclast activity → trabecular bone loss → vertebral crush + Colles fracture"),
    ("Type II (Senile >70):", "Cortical + trabecular; hip fracture; related to ↓Ca absorption"),
    ("Diagnosis:", "DEXA scan; T-score < -2.5 = osteoporosis; < -1 = osteopenia"),
    ("Labs:", "Normal Ca, PO4, ALP (distinguishes from Paget's & osteomalacia)"),
    ("Treatment:", "Bisphosphonates (alendronate — 1st line); Ca + Vit D; denosumab; teriparatide"),
    ("🦠 OSTEOMYELITIS:", ""),
    ("Acute:", "Staph aureus MC; long bone metaphysis (children); haematogenous; hot, tender, swollen"),
    ("Chronic:", "Sequestrum (dead bone — dark, separated); Involucrum (periosteal new bone envelope); Brodie abscess (localized walled-off cavity)"),
    ("Sickle cell:", "Salmonella MC (unusual — memorize!)"),
    ("Diabetic foot:", "Polymicrobial + Pseudomonas; metatarsals"),
], font_size=7.5, card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

# ══════════════════════════════════════════════════════════════════════════════
# SLIDE 7 — PULMONARY + INFECTIONS
# ══════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
page_header(s, "✸  TB  •  Pneumonia  •  Asthma  •  Meningitis  •  Liver", "5-Mark Topics", BG_CREAM, BUTTER)

bg, hdr, hdr_fg, ico = cc(5)
card(s, Inches(0.15), Inches(0.72), Inches(3.2), Inches(3.5), "Tuberculosis", [
    ("Organism:", "M. tuberculosis; AFB; Ziehl-Neelsen stain (red rods on blue)"),
    ("🌱 PRIMARY TB:", "Mid/lower lobe; Ghon focus + hilar LN = Ghon complex; heals with calcification"),
    ("🔴 SECONDARY TB:", "Upper lobe reactivation (Assmann focus); cavitation; haemoptysis"),
    ("Histology:", "Caseous necrosis + epithelioid granuloma + Langhans giant cells + lymphocyte cuff"),
    ("Miliary TB:", "Haematogenous spread → millet-seed lesions everywhere"),
    ("Complications:", "Cavitation, empyema, pneumothorax, amyloidosis, Addison's disease"),
    ("Lab:", "Mantoux/TST; IGRA (Quantiferon-Gold); AFB smear + Lowenstein-Jensen culture"),
], card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(3)
card(s, Inches(0.15), Inches(4.32), Inches(3.2), Inches(2.9), "Pneumonia", [
    ("LOBAR (Strep pneumoniae):", "Entire lobe consolidated; 4 stages: Congestion → Red hepatization → Grey hepatization → Resolution"),
    ("BRONCHO:", "Patchy; multiple lobules; elderly/infants; Staph, H. influenzae, Klebsiella"),
    ("ATYPICAL:", "Interstitial; Mycoplasma, Legionella, viral; 'walking pneumonia'; ground-glass on CT"),
    ("ASPIRATION:", "Right lower lobe; anaerobes; lung abscess"),
    ("Complications:", "Empyema, abscess, bacteraemia, fibrous pleuritis, ARDS"),
], card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(0)
card(s, Inches(3.5), Inches(0.72), Inches(3.3), Inches(3.1), "Asthma", [
    ("Type:", "Reversible obstructive airways disease; bronchospasm + mucus plugging + inflammation"),
    ("Extrinsic:", "IgE-mediated (Type I HSR); allergen → mast cell degranulation; ↑eosinophils, ↑IgE"),
    ("Intrinsic:", "Non-atopic; cold, exercise, infection, aspirin (↑LTs)"),
    ("🔬 Histology:", "Curschmann spirals (mucus casts), Charcot-Leyden crystals (eosinophil products), Creola bodies (shed epithelium), BM thickening, goblet cell hyperplasia, smooth muscle hypertrophy"),
    ("PFTs:", "↓FEV1, ↓FEV1/FVC; reversible post-bronchodilator (key feature)"),
    ("⚠️ Status asthmaticus:", "Silent chest = danger; CO2 starts rising = ominous sign"),
], card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(1)
card(s, Inches(3.5), Inches(3.92), Inches(3.3), Inches(3.3), "Meningitis — CSF Table", [
    ("",            "BACTERIAL         VIRAL"),
    ("Appearance:", "Turbid/cloudy     Clear"),
    ("Protein:",    ">100 mg/dL ↑↑    Mildly ↑"),
    ("Glucose:",    "<40 mg/dL ↓↓     Normal"),
    ("Cells:",      "PMNs (1000s)      Lymphocytes"),
    ("Org. adult:", "N. meningitidis,  Enteroviruses,"),
    ("",            "S. pneumoniae     HSV"),
    ("Org.neonate:","GBS, E. coli, Listeria"),
    ("TB mening.:", "Lymphs, ↑protein, ↓glucose, pellicle"),
    ("Treatment:",  "Ceftriaxone + Dexamethasone"),
], card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico, font_size=8)

bg, hdr, hdr_fg, ico = cc(2)
card(s, Inches(6.95), Inches(0.72), Inches(6.2), Inches(6.5), "Hepatitis & Cirrhosis", [
    ("🦠 CHRONIC HEPATITIS:", ""),
    ("Definition:", ">6 months of hepatic inflammation + necrosis + fibrosis"),
    ("Causes:", "HBV (most common worldwide), HCV (MC in West → cirrhosis), HDV (only with HBV), AIH, Wilson's, haemochromatosis, drugs (INH, methyldopa, nitrofurantoin)"),
    ("HBV MARKERS:", ""),
    ("HBsAg:", "Surface antigen = currently infected (window period: HBsAg +, anti-HBs −)"),
    ("HBeAg:", "Active viral replication = highly infectious"),
    ("Anti-HBc IgM:", "Acute infection (appears first + window period)"),
    ("Anti-HBc IgG:", "Past infection or chronic carrier"),
    ("Anti-HBs:", "Immunity — from vaccination or recovery"),
    ("HCV:", "RNA virus; no vaccine; Genotype 1 MC; cryoglobulinaemia, membranous GN; treat with DAAs (sofosbuvir)"),
    ("Histology:", "Interface hepatitis (piecemeal necrosis); portal lymphocytic infiltrate; bridging fibrosis → cirrhosis"),
    ("🌿 CIRRHOSIS:", ""),
    ("Definition:", "Irreversible diffuse hepatic fibrosis + regenerative nodules (no normal architecture)"),
    ("Micronodular (<3mm):", "Alcoholic cirrhosis; uniform nodules; Mallory hyaline bodies; centrilobular fibrosis; AST:ALT >2:1, ↑GGT"),
    ("Macronodular (>3mm):", "Viral (HBV/HCV), Wilson's, haemochromatosis, AIH"),
    ("Complications:", "Portal HTN → oesophageal varices (haematemesis), ascites (SBP risk), splenomegaly (hypersplenism), caput medusae, hepatic encephalopathy, HRS, HCC"),
    ("Labs:", "↑Bilirubin, ↑PT (↓clotting factors), ↓albumin, ↓platelets, ↑AST/ALT"),
], font_size=7.5, card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

# ══════════════════════════════════════════════════════════════════════════════
# SLIDE 8 — GI: STOMACH + PEPTIC ULCER
# ══════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
page_header(s, "✿  GI Pathology  •  Carcinoma Stomach  •  Peptic Ulcer Disease", "10M Topics", BG_CREAM, ROSE)

bg, hdr, hdr_fg, ico = cc(0)
card(s, Inches(0.15), Inches(0.72), Inches(6.4), Inches(6.5), "Carcinoma of Stomach", [
    ("ETIOLOGY:", "H. pylori (MC — CagA+ strains), dietary nitrosamines, smoked/cured food, ↓fruits/veg, smoking, EBV, blood group A, intestinal metaplasia, pernicious anaemia, gastric adenoma, partial gastrectomy"),
    ("PATHOGENESIS:", "H. pylori → chronic gastritis → atrophy → intestinal metaplasia → dysplasia → carcinoma"),
    ("🍃 LAUREN CLASSIFICATION:", ""),
    ("Intestinal type:", "Glandular structure; blood-borne spread (liver); associated with H. pylori + IM; older men; better prognosis"),
    ("Diffuse type:", "Poorly differentiated; SIGNET RING CELLS (mucin pushes nucleus to periphery); CDH1 (E-cadherin) mutation; linitis plastica; peritoneal spread; younger; worse prognosis"),
    ("SITES:", "Antrum/pylorus MC (50%), lesser curvature (25%), cardia (10%)"),
    ("📐 GROSS MORPHOLOGY:", ""),
    ("Early Ca:", "Confined to mucosa/submucosa; excellent prognosis; MC in Japan (screening)"),
    ("Fungating:", "Polypoid, projecting into lumen; exophytic"),
    ("Ulcerating:", "Raised, irregular, everted edges (malignant) vs. punched-out regular (benign ulcer)"),
    ("Infiltrating:", "Linitis plastica — thickened, leather-bottle stomach; diffuse type"),
    ("🔬 MICROSCOPY:", "Intestinal: tubular/papillary glands; Diffuse: signet ring cells; Poorly diff: solid sheets"),
    ("🌐 SPREAD:", "Direct — pancreas, liver; Lymph — Virchow's node (left supraclavicular = Troisier sign); Transcoelomic — Krukenberg (ovary), Blumer shelf (pouch of Douglas); Haematogenous — liver, lung, bone"),
    ("Paraneoplastic:", "Acanthosis nigricans (velvety hyperpigmented axilla), Leser-Trélat sign (sudden ↑seborrheic keratoses)"),
    ("Prognosis:", "5yr survival: Early >90%; Advanced stage II ~30%, stage IV <5%"),
], font_size=7.8, card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(1)
card(s, Inches(6.7), Inches(0.72), Inches(6.45), Inches(6.5), "Peptic Ulcer Disease (PUD)", [
    ("TYPES + KEY DIFFERENCES:", ""),
    ("",           "DUODENAL ULCER (DU)     GASTRIC ULCER (GU)"),
    ("Site:",      "1st part duodenum       Lesser curvature antrum"),
    ("Acid:",      "↑ production            Normal or ↓"),
    ("Pain:",      "Hunger pain, 2-3AM      Worsened by food"),
    ("Malignant:", "NEVER                   Possible (biopsy!)"),
    ("H. pylori:", ">95%                    75%"),
    ("🦠 H. PYLORI MECHANISM:", ""),
    ("Path:", "Damages mucus layer; urease → NH3 → antrum alkaline → ↑gastrin → ↑acid; CagA/VacA toxins damage epithelium"),
    ("💊 NSAID MECHANISM:", "COX-1 inhibition → ↓PGE2 → ↓mucus, ↓bicarbonate, ↓mucosal blood flow → injury"),
    ("📐 MORPHOLOGY:", ""),
    ("Benign ulcer:", "Punched-out, smooth, regular edges; mucosal folds radiate to base; clean flat base"),
    ("Malignant:", "Irregular raised everted edges; nodular base; folds do NOT reach edge"),
    ("Histology:", "4 zones: fibrinous exudate → fibrinoid necrosis → granulation tissue → fibrous scar (base)"),
    ("🩺 CLINICAL:", "Epigastric pain, heartburn, nausea; DU: hunger pain at night; GU: post-prandial pain"),
    ("🔎 INVESTIGATIONS:", "Urea breath test (H. pylori); Endoscopy + biopsy (gold standard); CLO test (rapid urease); barium meal (less used now)"),
    ("⚠️ COMPLICATIONS:", ""),
    ("Perforation:", "MC emergency; anterior DU; board-like abdomen; subdiaphragmatic air on erect CXR"),
    ("Haemorrhage:", "MC complication; posterior DU → gastroduodenal artery erosion; haematemesis/melaena"),
    ("Pyloric stenosis:", "Fibrosis → gastric outlet obstruction; projectile vomiting; succussion splash"),
    ("Penetration:", "Into pancreas → back pain; ↑amylase/lipase"),
    ("Malignant change:", "GU only (DU = never malignant)"),
    ("💊 TREATMENT:", "Triple therapy: PPI + clarithromycin + amoxicillin (7-14 days); PPI for 8 wks; surgery for complications"),
], font_size=7.5, card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

# ══════════════════════════════════════════════════════════════════════════════
# SLIDE 9 — BREAST + CERVIX + PCOD + OVARIAN
# ══════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
page_header(s, "❋  Female Pathology  •  Breast  •  Cervix  •  PCOD  •  Ovarian Tumors", "10M + 5M", BG_CREAM, LAVENDER)

bg, hdr, hdr_fg, ico = cc(1)
card(s, Inches(0.15), Inches(0.72), Inches(4.3), Inches(6.5), "Carcinoma Breast", [
    ("RISK FACTORS:", "Female, age>50, BRCA1/2, FH, early menarche, late menopause, nulliparity, OCP/HRT, obesity, radiation, alcohol, atypical hyperplasia"),
    ("BRCA1 (chr 17q):", "↑Breast + ovarian Ca; triple-negative tumors; defective HR repair"),
    ("BRCA2 (chr 13q):", "↑Breast (incl. male) + pancreatic Ca; Fanconi anaemia pathway"),
    ("TYPES:", ""),
    ("IDC-NOS (70%):", "MC type; firm gritty mass; stellate on mammogram; desmoplastic stroma"),
    ("ILC (10%):", "Indian file/single file pattern; bilateral; E-cadherin loss (CDH1)"),
    ("DCIS:", "Pre-invasive; comedo type (central necrosis + calcifications → detected on mammogram)"),
    ("Medullary:", "Large cells, lymphocyte-rich; BRCA1; paradoxically better prognosis"),
    ("Mucinous:", "Mucin lakes; older women; better prognosis"),
    ("Inflammatory:", "Dermal lymphatic invasion; peau d'orange; worst prognosis of all"),
    ("🎗 PAGET DISEASE:", "Intraepidermal spread of ductal adenocarcinoma to nipple; eczematous red nipple; Paget cells (large, pale, clear halo, +PAS); always underlying DCIS or IDC"),
    ("GRADING (Nottingham):", "Tubule formation + nuclear pleomorphism + mitotic count → Grade I-III"),
    ("RECEPTORS:", "ER+/PR+ (60%): tamoxifen/aromatase inhibitors; HER2+ (20%): trastuzumab; Triple-negative: chemo only; BRCA1 associated"),
    ("STAGING:", "TNM; sentinel LN biopsy; axillary clearance if +ve"),
    ("SPREAD:", "Axillary LN (MC); peau d'orange; distant: bone (osteolytic), lung, liver, brain"),
], font_size=7.5, card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(3)
card(s, Inches(4.6), Inches(0.72), Inches(3.0), Inches(3.2), "Carcinoma Cervix", [
    ("HPV:", "HPV 16 (SCC, MC) & HPV 18 (adenoCA); E6 inactivates p53; E7 inactivates Rb"),
    ("Site:", "Squamocolumnar junction (transformation zone)"),
    ("Progression:", "HPV infection → CIN I → II → III → CIS → Invasive (years)"),
    ("Types:", "SCC 80%, Adenocarcinoma 15%"),
    ("Screening:", "Pap smear (Papanicolaou) + HPV co-testing; colposcopy → biopsy"),
    ("Pap findings:", "Koilocytes (perinuclear halo = HPV), dysplastic cells, ↑N:C ratio"),
    ("Spread:", "Direct (bladder, rectum, vagina); parametrial; haematogenous late"),
    ("Vaccine:", "Gardasil 9 (HPV 6,11,16,18,31,33,45,52,58)"),
    ("Treatment:", "CIN: LEEP/cone biopsy; Invasive: radical hysterectomy + chemoradiation"),
], card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(5)
card(s, Inches(4.6), Inches(4.02), Inches(3.0), Inches(3.2), "PCOD", [
    ("Definition:", "Chronic anovulation + hyperandrogenism; MC endocrine disorder in women"),
    ("Pathogenesis:", "↑LH:FSH (>2:1) → ↑androgen (theca cells) → peripheral aromatization → ↑estrone → feedback blocks FSH → no ovulation → follicular cysts"),
    ("Features:", "Oligomenorrhea/amenorrhea, hirsutism, acne, obesity, infertility, acanthosis nigricans (insulin resistance)"),
    ("Gross:", "Enlarged bilateral ovaries; multiple small follicles (necklace sign on US); thickened capsule; stromal hyperplasia"),
    ("Labs:", "↑LH:FSH >2, ↑androgens, ↑AMH, ↑insulin; USG: ≥12 follicles/ovary"),
    ("Risks:", "Type 2 DM, endometrial Ca (unopposed estrogen), CVD, metabolic syndrome"),
], card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(4)
card(s, Inches(7.75), Inches(0.72), Inches(5.4), Inches(6.5), "Ovarian Tumors", [
    ("🌸 SURFACE EPITHELIAL (65%):", ""),
    ("Serous cystadenoma/CA:", "MC ovarian tumor; bilateral (30%); psammoma bodies (concentric calcifications); CA125 marker; BRCA1/2"),
    ("Mucinous:", "Large multilocular cyst; pseudomyxoma peritonei (mucin floods abdomen); CEA marker"),
    ("Endometrioid:", "Associated with endometriosis; looks like endometrial carcinoma"),
    ("Brenner:", "Transitional/urothelial cells; Walthard nests; mostly benign; tea-coloured cyst"),
    ("🌟 GERM CELL TUMORS (20%, young women):", ""),
    ("Mature cystic teratoma:", "MC germ cell tumor; dermoid cyst; hair + teeth + sebum; struma ovarii (thyroid tissue → hyperthyroidism)"),
    ("Immature teratoma:", "Malignant; primitive neural tissue; ↑AFP"),
    ("Dysgerminoma:", "Analogous to testicular seminoma; ↑LDH; radiosensitive; best prognosis of malignant GCTs"),
    ("Yolk sac tumor:", "MC malignant GCT in children; Schiller-Duval bodies (glomeruloid structures); ↑↑AFP"),
    ("Choriocarcinoma:", "↑↑β-hCG; follows molar pregnancy; highly malignant"),
    ("💜 SEX CORD-STROMAL (5%):", ""),
    ("Granulosa cell:", "Estrogen-producing → precocious puberty (children) / post-menopausal bleeding (adults); Call-Exner bodies; ↑inhibin (marker)"),
    ("Thecoma-fibroma:", "Fibroma: Meigs syndrome (ovarian fibroma + ascites + right pleural effusion); thecoma: estrogen-producing"),
    ("Sertoli-Leydig:", "Androgen-producing → virilization (hirsutism, clitoromegaly)"),
    ("📊 STAGING:", "FIGO; Stage I = confined to ovaries; Stage III = peritoneal/LN; Stage IV = distant mets"),
], font_size=7.5, card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

# ══════════════════════════════════════════════════════════════════════════════
# SLIDE 10 — NEOPLASIA + DM + CEREBROVASCULAR
# ══════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
page_header(s, "◈  Neoplasia  •  Benign vs Malignant  •  DM  •  Cerebrovascular", "5M + 10M Topics", BG_CREAM, PEACH)

bg, hdr, hdr_fg, ico = cc(3)
card(s, Inches(0.15), Inches(0.72), Inches(5.5), Inches(6.5), "Neoplasia — Define, Classify, Benign vs Malignant", [
    ("DEFINITION:", "Abnormal, uncontrolled, purposeless proliferation of cells that persists even after removal of initiating stimulus (Willis, 1952)"),
    ("CLASSIFICATION:", ""),
    ("Epithelial — benign:", "Adenoma (gland), Papilloma (surface), Cystadenoma"),
    ("Epithelial — malignant:", "Carcinoma (adenocarcinoma, SCC, transitional cell Ca)"),
    ("Mesenchymal — benign:", "Lipoma, Fibroma, Chondroma, Osteoma, Leiomyoma"),
    ("Mesenchymal — malignant:", "Sarcoma (liposarcoma, fibrosarcoma, osteosarcoma)"),
    ("Mixed tumors:", "Fibroadenoma (breast), pleomorphic adenoma (salivary)"),
    ("Germ cell:", "Teratoma, dysgerminoma, seminoma"),
    ("📊 BENIGN vs MALIGNANT:", ""),
    ("",                "BENIGN              MALIGNANT"),
    ("Differentiation:", "Well diff           Poorly diff/anaplastic"),
    ("Growth:",         "Slow, expansile     Rapid, infiltrative"),
    ("Capsule:",        "Present             Absent"),
    ("Mitoses:",        "Rare, normal        Frequent, atypical"),
    ("Necrosis:",       "Absent              Common"),
    ("Metastasis:",     "NEVER ← KEY         YES — defines malignancy"),
    ("Recurrence:",     "Rare after excision Common"),
    ("Nuclei:",         "Normal N:C ratio    ↑N:C, hyperchromia, prominent nucleoli"),
    ("GRADING:", "Degree of differentiation (I-IV); histological"),
    ("STAGING (TNM):", "T=tumour size; N=nodal status; M=metastasis; most important for prognosis"),
    ("CARCINOGENESIS:", "Initiation (mutagen) → Promotion (proliferation) → Progression (invasion/mets)"),
    ("Oncogenes:", "Dominant gain-of-function; RAS (MC point mutation), MYC (Burkitt translocation), HER2 (amplification), BCR-ABL (translocation)"),
    ("Tumour suppressors:", "Recessive loss-of-fn (2-hit); RB (retinoblastoma), TP53 (guardian of genome), APC (colon Ca), BRCA1/2"),
], font_size=7.5, card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(0)
card(s, Inches(5.8), Inches(0.72), Inches(3.55), Inches(3.2), "Type I Diabetes Mellitus", [
    ("Type:", "Autoimmune destruction of pancreatic β cells (islets of Langerhans)"),
    ("HLA:", "HLA-DR3 and HLA-DR4 (strongest genetic association)"),
    ("Autoantibodies:", "Anti-GAD65 (most specific), anti-islet cell (ICA), anti-insulin (IAA)"),
    ("Onset:", "Childhood/adolescence; lean/normal weight; abrupt onset"),
    ("C-peptide:", "Low/absent (no endogenous insulin production)"),
    ("DKA:", "Prone to diabetic ketoacidosis (no insulin → ↑FFA → ketogenesis)"),
    ("Histology:", "Lymphocytic insulitis (early); β cell loss; no amyloid (cf. Type II = IAPP deposits)"),
    ("Complications:", "Microvascular: retinopathy (MC), nephropathy, neuropathy; Macrovascular: CAD, stroke, PVD"),
    ("Treatment:", "Insulin (mandatory — basal-bolus regimen); no insulin = death"),
], card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(2)
card(s, Inches(5.8), Inches(4.02), Inches(3.55), Inches(3.2), "Cerebral Infarction + CVD", [
    ("ISCHEMIC STROKE (80%):", "Thrombosis (in-situ atherosclerosis) or Embolism (AF, MI, carotid); MCA territory MC (face + arm)"),
    ("Pathology:", "Liquefactive necrosis (brain unique!); pale infarct → softens → cystic cavity (weeks)"),
    ("HEMORRHAGIC (20%):", "ICH: hypertensive; lenticulostriate arteries; putamen MC; SAH: Berry aneurysm (ACoA MC), AVM"),
    ("TIA:", "<24h resolution; same mechanisms; high early stroke risk"),
    ("MCA stroke:", "Contralateral hemiplegia (face + arm > leg), hemianopia, aphasia (dominant hemisphere)"),
    ("CVD causes:", "HTN (#1), atherosclerosis, AF (cardioembolic), coagulopathy, vasculitis, drug abuse"),
    ("CT:", "Hemorrhage = hyperdense (white) acutely; Ischemia = hypodense (dark) after 24h"),
    ("MRI DWI:", "Ischemia bright within minutes-hours (diffusion restriction)"),
    ("Treatment:", "IV tPA within 4.5h for ischemic; thrombectomy up to 24h (large vessel occlusion)"),
], card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

bg, hdr, hdr_fg, ico = cc(5)
card(s, Inches(9.5), Inches(0.72), Inches(3.65), Inches(6.5), "Retinoblastoma • Rheumatic Heart • Thrombosis", [
    ("👁 RETINOBLASTOMA:", ""),
    ("Gene:", "RB1 (13q14) tumour suppressor; 2-hit hypothesis (Knudson)"),
    ("Presentation:", "Leukocoria (white reflex, MC presenting feature), strabismus, ↓vision"),
    ("Age:", "Children <5 yrs; bilateral = germline (heritable); unilateral often sporadic somatic"),
    ("Histology:", "Flexner-Wintersteiner rosettes (photoreceptor differentiation); Homer-Wright rosettes (generic)"),
    ("Treatment:", "Enucleation (large); chemo + radiotherapy (small/bilateral)"),
    ("♥️ RHEUMATIC HEART DISEASE:", ""),
    ("Mechanism:", "Group A β-Strep throat → antibodies cross-react with cardiac tissue (molecular mimicry) → pancarditis"),
    ("Jones criteria:", "Major: Carditis, Polyarthritis (migratory), Chorea (Sydenham's), Erythema marginatum, Subcutaneous nodules"),
    ("Aschoff bodies:", "Pathognomonic granuloma; Anitschkow cells (caterpillar/owl eye nuclei)"),
    ("Valves:", "Mitral MC (fish-mouth stenosis), then aortic; tricuspid + pulmonary rare"),
    ("Mitral stenosis:", "LA enlargement → AF → systemic emboli; dysphagia (LA compression); hemoptysis"),
    ("Prevent:", "Penicillin G prophylaxis after every Strep throat; rheumatic fever → lifelong prophylaxis"),
    ("💉 THROMBOSIS recap:", ""),
    ("Virchow:", "Injury + Stasis + Hypercoagulability"),
    ("DVT → PE:", "Saddle embolus (bifurcation); Hampton's hump (wedge opacity); Westermark sign (oligaemia)"),
], font_size=7.5, card_bg=bg, title_bg=hdr, title_fg=hdr_fg, icon=ico)

# ══════════════════════════════════════════════════════════════════════════════
# SLIDE 11 — RAPID REVIEW BUZZWORDS
# ══════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
fill_bg(s, BG_CREAM)
add_rect(s, 0, 0, W, Inches(0.08), ROSE)
add_rect(s, 0, Inches(0.08), W, Inches(0.56), BG_BLUSH)
add_text(s, "✸  Rapid Review  —  High-Yield Buzzwords & One-Liners  ✸",
         Inches(0.35), Inches(0.08), Inches(12), Inches(0.52),
         19, bold=True, color=HEADING_DARK, align=PP_ALIGN.CENTER, font="Georgia")
add_rect(s, 0, Inches(0.64), W, Pt(1.5), DUSTY_PINK)

col1 = [
    ("Psammoma bodies →", "Serous ovarian Ca, meningioma, papillary thyroid Ca, mesothelioma"),
    ("Schiller-Duval bodies →", "Yolk sac tumor (↑AFP)"),
    ("Call-Exner bodies →", "Granulosa cell tumor (↑inhibin)"),
    ("Flexner-Wintersteiner →", "Retinoblastoma"),
    ("Aschoff bodies →", "Rheumatic fever (Anitschkow cells)"),
    ("Mallory hyaline →", "Alcoholic hepatitis"),
    ("Kimmelstiel-Wilson →", "Diabetic nephropathy (nodular GS)"),
    ("Curschmann spirals →", "Asthma (mucus casts)"),
    ("Charcot-Leyden crystals →", "Asthma (eosinophil breakdown products)"),
    ("Creola bodies →", "Asthma (shed airway epithelium)"),
    ("Virchow's node →", "Left supraclavicular; gastric Ca"),
    ("Krukenberg tumor →", "Gastric Ca → ovary (signet ring cells)"),
    ("Linitis plastica →", "Diffuse gastric Ca (leather-bottle stomach)"),
    ("Acanthosis nigricans →", "Gastric Ca (paraneoplastic) / PCOD / DM"),
]

col2 = [
    ("LAP score LOW →", "CML; Philadelphia chr t(9;22), BCR-ABL"),
    ("LAP score HIGH →", "Leukemoid reaction"),
    ("Hyperseg. neutrophils →", "Megaloblastic anaemia (≥5 lobes)"),
    ("Koilocytes →", "HPV (cervical Pap smear)"),
    ("Spike & dome →", "Membranous GN (subepithelial deposits)"),
    ("Foot process fusion →", "Minimal Change Disease (EM only)"),
    ("Wire loop lesion →", "Lupus nephritis (SLE)"),
    ("Indian file pattern →", "Invasive lobular breast Ca"),
    ("Peau d'orange →", "Inflammatory breast Ca"),
    ("Brodie abscess →", "Chronic osteomyelitis"),
    ("Sequestrum →", "Dead bone in osteomyelitis"),
    ("Involucrum →", "New periosteal bone in osteomyelitis"),
    ("Ghon complex →", "Primary TB (focus + hilar LN)"),
    ("Leukocoria →", "Retinoblastoma (white pupillary reflex)"),
]

col3 = [
    ("FENa < 1% →", "Pre-renal AKI"),
    ("FENa > 2% →", "Intrinsic renal (ATN)"),
    ("Muddy brown casts →", "Acute tubular necrosis (ATN)"),
    ("Oval fat bodies →", "Nephrotic syndrome"),
    ("Troponin I/T →", "Most specific for MI; 4-6h rise; 7-10d duration"),
    ("CK-MB →", "Rises 4-8h; normalises 48-72h (reinfarction)"),
    ("AST:ALT > 2:1 →", "Alcoholic hepatitis (+ ↑GGT)"),
    ("Anti-HBs →", "Immunity (vaccination or recovery from HBV)"),
    ("HBeAg →", "Active HBV replication / highly infectious"),
    ("BCR-ABL t(9;22) →", "CML (Philadelphia chromosome)"),
    ("EBV →", "Burkitt (c-MYC), Hodgkin's, nasopharyngeal Ca"),
    ("H. pylori →", "Gastric Ca + MALT lymphoma + peptic ulcer"),
    ("VHL mutation →", "Clear cell RCC (most common RCC)"),
    ("WT1 mutation →", "Wilms tumor (nephroblastoma)"),
]

# three styled columns
for i, (col, title) in enumerate([(col1, "Histological Buzzwords ✿"),
                                    (col2, "Classic Patterns ❋"),
                                    (col3, "Lab Markers & Genes ✦")]):
    cx = Inches(0.15 + i * 4.38)
    cbg, chdr, chdr_fg, cico = cc(i*2)
    add_rounded_rect(s, cx+Pt(3), Inches(0.72+0.03), Inches(4.22), Inches(6.5), RGBColor(0xE8,0xDC,0xDC))
    add_rounded_rect(s, cx, Inches(0.72), Inches(4.22), Inches(6.5), cbg, RGBColor(0xE0,0xCC,0xCC), Pt(0.5))
    add_rect(s, cx, Inches(0.72), Inches(4.22), Inches(0.30), chdr)
    add_text(s, title, cx+Pt(6), Inches(0.73), Inches(4.1), Inches(0.28),
             9.5, bold=True, color=chdr_fg, font="Georgia")
    add_ml(s, col, cx+Pt(6), Inches(1.04), Inches(4.1), Inches(6.15),
           8, body_color=DARK_BROWN, label_color=LABEL_COL)

# ── SAVE ──────────────────────────────────────────────────────────────────────
out = "/tmp/workspace/patho-cheatsheet/Pathology_Pinterest_CheatSheet.pptx"
buf = BytesIO()
prs.save(buf)
with open(out, "wb") as f:
    f.write(buf.getvalue())
print(f"✿ Saved: {out}")