pediatric viva important questions growth development neonatology immunization nutrition

mkdir -p /home/daytona/workspace/pediatrics-pdf && ls /home/daytona/workspace/

~/pediatrics-pdf/generate_pdf.py

#!/usr/bin/env python3
"""
Pediatrics 1st Internal Exam - Comprehensive Quick Reference PDF
"""

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

# ── Color Palette ──────────────────────────────────────────────────────────────
NAVY       = colors.HexColor("#1a2b5e")
TEAL       = colors.HexColor("#00838f")
ORANGE     = colors.HexColor("#e65100")
LIGHT_BLUE = colors.HexColor("#e3f2fd")
LIGHT_TEAL = colors.HexColor("#e0f7fa")
LIGHT_ORANGE= colors.HexColor("#fff3e0")
LIGHT_GRAY = colors.HexColor("#f5f5f5")
MID_GRAY   = colors.HexColor("#eceff1")
WHITE      = colors.white
DARK_TEXT  = colors.HexColor("#212121")
RED_ACCENT = colors.HexColor("#c62828")
GREEN_ACCENT= colors.HexColor("#2e7d32")
PURPLE     = colors.HexColor("#6a1b9a")

W, H = A4

def build_styles():
    base = getSampleStyleSheet()

    styles = {}

    styles["cover_title"] = ParagraphStyle(
        "cover_title", fontName="Helvetica-Bold", fontSize=28,
        textColor=WHITE, alignment=TA_CENTER, leading=34, spaceAfter=6
    )
    styles["cover_sub"] = ParagraphStyle(
        "cover_sub", fontName="Helvetica", fontSize=14,
        textColor=colors.HexColor("#b3e5fc"), alignment=TA_CENTER, leading=18
    )
    styles["cover_badge"] = ParagraphStyle(
        "cover_badge", fontName="Helvetica-Bold", fontSize=12,
        textColor=WHITE, alignment=TA_CENTER, leading=16
    )
    styles["topic_num"] = ParagraphStyle(
        "topic_num", fontName="Helvetica-Bold", fontSize=22,
        textColor=WHITE, alignment=TA_CENTER, leading=26
    )
    styles["section_title"] = ParagraphStyle(
        "section_title", fontName="Helvetica-Bold", fontSize=15,
        textColor=WHITE, alignment=TA_LEFT, leading=20,
        leftIndent=8
    )
    styles["sub_heading"] = ParagraphStyle(
        "sub_heading", fontName="Helvetica-Bold", fontSize=11,
        textColor=NAVY, alignment=TA_LEFT, leading=15,
        spaceAfter=3, spaceBefore=6,
        borderPad=2
    )
    styles["body"] = ParagraphStyle(
        "body", fontName="Helvetica", fontSize=9,
        textColor=DARK_TEXT, alignment=TA_LEFT, leading=13,
        spaceAfter=3
    )
    styles["bullet"] = ParagraphStyle(
        "bullet", fontName="Helvetica", fontSize=9,
        textColor=DARK_TEXT, alignment=TA_LEFT, leading=13,
        leftIndent=12, firstLineIndent=-8, spaceAfter=2
    )
    styles["highlight_box"] = ParagraphStyle(
        "highlight_box", fontName="Helvetica-Bold", fontSize=9,
        textColor=RED_ACCENT, alignment=TA_LEFT, leading=13,
        leftIndent=4
    )
    styles["key_point"] = ParagraphStyle(
        "key_point", fontName="Helvetica-BoldOblique", fontSize=9,
        textColor=GREEN_ACCENT, alignment=TA_LEFT, leading=13,
        leftIndent=4
    )
    styles["mnemonic"] = ParagraphStyle(
        "mnemonic", fontName="Helvetica-Bold", fontSize=9,
        textColor=PURPLE, alignment=TA_LEFT, leading=13,
        leftIndent=4
    )
    styles["footer_text"] = ParagraphStyle(
        "footer_text", fontName="Helvetica", fontSize=7,
        textColor=colors.HexColor("#90a4ae"), alignment=TA_CENTER
    )
    styles["toc_entry"] = ParagraphStyle(
        "toc_entry", fontName="Helvetica", fontSize=10,
        textColor=NAVY, alignment=TA_LEFT, leading=16,
        leftIndent=20
    )
    styles["toc_num"] = ParagraphStyle(
        "toc_num", fontName="Helvetica-Bold", fontSize=10,
        textColor=TEAL, alignment=TA_LEFT, leading=16
    )
    return styles

S = build_styles()

def section_header(title, color=NAVY, num=None):
    """Returns a colored banner for a topic section."""
    label = f"  {num}  " if num else "  "
    data = [[
        Paragraph(label, ParagraphStyle("n", fontName="Helvetica-Bold", fontSize=16,
                                        textColor=WHITE, alignment=TA_CENTER, leading=20)),
        Paragraph(title, S["section_title"])
    ]]
    col_widths = [1.2*cm, 16*cm]
    t = Table(data, colWidths=col_widths)
    t.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), color),
        ("VALIGN",     (0,0), (-1,-1), "MIDDLE"),
        ("LEFTPADDING",(0,0), (-1,-1), 4),
        ("RIGHTPADDING",(0,0),(-1,-1), 4),
        ("TOPPADDING", (0,0), (-1,-1), 6),
        ("BOTTOMPADDING",(0,0),(-1,-1), 6),
        ("ROUNDEDCORNERS", [4, 4, 4, 4]),
    ]))
    return t

def sub_header(text, color=TEAL):
    data = [[Paragraph(f"  {text}", ParagraphStyle(
        "sh", fontName="Helvetica-Bold", fontSize=10,
        textColor=WHITE, alignment=TA_LEFT, leading=14
    ))]]
    t = Table(data, colWidths=[17.2*cm])
    t.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), color),
        ("TOPPADDING", (0,0), (-1,-1), 4),
        ("BOTTOMPADDING",(0,0),(-1,-1), 4),
        ("LEFTPADDING", (0,0), (-1,-1), 6),
    ]))
    return t

def make_table(headers, rows, col_widths=None, header_color=NAVY, alt_color=LIGHT_GRAY):
    data = [headers] + rows
    if col_widths is None:
        n = len(headers)
        col_widths = [17.2*cm / n] * n

    t = Table(data, colWidths=col_widths, repeatRows=1)
    style = [
        ("BACKGROUND", (0,0), (-1,0), header_color),
        ("TEXTCOLOR",  (0,0), (-1,0), WHITE),
        ("FONTNAME",   (0,0), (-1,0), "Helvetica-Bold"),
        ("FONTSIZE",   (0,0), (-1,0), 8.5),
        ("ALIGN",      (0,0), (-1,0), "CENTER"),
        ("VALIGN",     (0,0), (-1,-1), "MIDDLE"),
        ("FONTNAME",   (0,1), (-1,-1), "Helvetica"),
        ("FONTSIZE",   (0,1), (-1,-1), 8),
        ("GRID",       (0,0), (-1,-1), 0.4, colors.HexColor("#b0bec5")),
        ("ROWBACKGROUNDS", (0,1), (-1,-1), [WHITE, alt_color]),
        ("LEFTPADDING",  (0,0), (-1,-1), 4),
        ("RIGHTPADDING", (0,0), (-1,-1), 4),
        ("TOPPADDING",   (0,0), (-1,-1), 3),
        ("BOTTOMPADDING",(0,0), (-1,-1), 3),
    ]
    t.setStyle(TableStyle(style))
    return t

def info_box(text, bg=LIGHT_BLUE, border=TEAL):
    data = [[Paragraph(text, S["body"])]]
    t = Table(data, colWidths=[17.2*cm])
    t.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), bg),
        ("LINEAFTER",  (0,0), (0,-1), 3, border),
        ("LEFTPADDING",(0,0), (-1,-1), 8),
        ("RIGHTPADDING",(0,0),(-1,-1), 6),
        ("TOPPADDING", (0,0), (-1,-1), 5),
        ("BOTTOMPADDING",(0,0),(-1,-1), 5),
    ]))
    return t

def b(text): return f"<b>{text}</b>"
def red(text): return f'<font color="#c62828"><b>{text}</b></font>'
def grn(text): return f'<font color="#2e7d32"><b>{text}</b></font>'
def teal_t(text): return f'<font color="#00838f"><b>{text}</b></font>'
def orange_t(text): return f'<font color="#e65100"><b>{text}</b></font>'

def bullet(text):
    return Paragraph(f"• {text}", S["bullet"])

def sp(n=4): return Spacer(1, n)

# ══════════════════════════════════════════════════════════════════════════════
# PAGE CALLBACKS
# ══════════════════════════════════════════════════════════════════════════════

PAGE_NUM = [0]

def on_page(canvas, doc):
    PAGE_NUM[0] += 1
    canvas.saveState()
    # Header bar
    canvas.setFillColor(NAVY)
    canvas.rect(0, H - 1.0*cm, W, 1.0*cm, fill=1, stroke=0)
    canvas.setFont("Helvetica-Bold", 8)
    canvas.setFillColor(WHITE)
    canvas.drawString(1*cm, H - 0.65*cm, "PEDIATRICS — 1st Internal Exam Quick Reference")
    canvas.drawRightString(W - 1*cm, H - 0.65*cm, "Viva Preparation Guide")
    # Footer bar
    canvas.setFillColor(NAVY)
    canvas.rect(0, 0, W, 0.75*cm, fill=1, stroke=0)
    canvas.setFont("Helvetica", 7.5)
    canvas.setFillColor(WHITE)
    canvas.drawCentredString(W/2, 0.22*cm, f"Page {PAGE_NUM[0]}")
    canvas.restoreState()

def on_cover_page(canvas, doc):
    canvas.saveState()
    # Full-page gradient-like background
    canvas.setFillColor(NAVY)
    canvas.rect(0, 0, W, H, fill=1, stroke=0)
    # Accent strip
    canvas.setFillColor(TEAL)
    canvas.rect(0, H*0.38, W, 6, fill=1, stroke=0)
    canvas.setFillColor(ORANGE)
    canvas.rect(0, H*0.38 - 8, W, 6, fill=1, stroke=0)
    canvas.restoreState()

# ══════════════════════════════════════════════════════════════════════════════
# CONTENT BUILDERS
# ══════════════════════════════════════════════════════════════════════════════

def cover_page():
    items = []
    items.append(Spacer(1, 3.5*cm))
    items.append(Paragraph("🩺 PEDIATRICS", S["cover_title"]))
    items.append(Spacer(1, 0.3*cm))
    items.append(Paragraph("1st Internal Examination", S["cover_sub"]))
    items.append(Paragraph("Comprehensive Quick Reference", S["cover_sub"]))
    items.append(Spacer(1, 0.8*cm))
    items.append(HRFlowable(width="60%", thickness=2, color=TEAL, spaceAfter=12))

    # Topic boxes
    topics = [
        ("1","Growth & Development"), ("2","Nutrition"),
        ("3","Neonatology"),          ("4","Immunization"),
        ("5","Diseases of GIT"),      ("6","Infections & Infestations"),
        ("7","Adolescent Medicine"),  ("8","Respiratory System"),
        ("9","Haematological Disorders"), ("10","Renal Disorders"),
    ]
    col1 = [[Paragraph(f"<b>{n}.</b> {t}", ParagraphStyle(
        "tp", fontName="Helvetica", fontSize=11, textColor=WHITE,
        leading=16, alignment=TA_LEFT
    ))] for n,t in topics[:5]]
    col2 = [[Paragraph(f"<b>{n}.</b> {t}", ParagraphStyle(
        "tp2", fontName="Helvetica", fontSize=11, textColor=WHITE,
        leading=16, alignment=TA_LEFT
    ))] for n,t in topics[5:]]

    tdata = [[Table(col1, colWidths=[8.6*cm]), Table(col2, colWidths=[8.6*cm])]]
    tbl = Table(tdata, colWidths=[8.6*cm, 8.6*cm])
    tbl.setStyle(TableStyle([
        ("VALIGN", (0,0), (-1,-1), "TOP"),
        ("LEFTPADDING", (0,0), (-1,-1), 10),
    ]))
    items.append(tbl)
    items.append(Spacer(1, 1.2*cm))
    items.append(HRFlowable(width="60%", thickness=2, color=ORANGE, spaceAfter=12))
    items.append(Paragraph("For MBBS / BDS / BSc Nursing Students", S["cover_badge"]))
    items.append(Spacer(1, 0.3*cm))
    items.append(Paragraph("Quick-reference format | Tables | Mnemonics | Viva Q&A", S["cover_sub"]))
    return items


def topic1():
    """Growth & Development"""
    items = []
    items.append(section_header("GROWTH & DEVELOPMENT", NAVY, "1"))
    items.append(sp(6))

    # Weight & Height
    items.append(sub_header("Weight & Height Milestones", TEAL))
    items.append(sp(4))
    wh_data = [
        [b("Age"), b("Weight"), b("Height")],
        ["Birth", "~3 kg", "~50 cm"],
        ["5 months", "Double (6 kg)", "—"],
        ["1 year", "Triple (9 kg)", "75 cm (1.5×)"],
        ["2 years", "Quadruple (12 kg)", "87 cm"],
        ["3-10 years", "+2 kg/year", "+6 cm/year"],
    ]
    items.append(make_table(wh_data[0], wh_data[1:], col_widths=[5.7*cm,5.7*cm,5.7*cm]))
    items.append(sp(6))

    # Head circumference
    items.append(sub_header("Head Circumference & Fontanelle", TEAL))
    items.append(sp(4))
    hc_data = [
        [b("Age"), b("HC"), b("Notes")],
        ["Birth", "34 cm", "Posterior fontanelle closes by 6-8 weeks"],
        ["3 months", "40 cm", "+2 cm/month for 1st 3 months"],
        ["6 months", "44 cm", "+1 cm/month from 3-12 months"],
        ["1 year", "47 cm", "Anterior fontanelle closes 12-18 months"],
        ["2 years", "49 cm", "Normal ant. fontanelle size = 2×2 cm"],
    ]
    items.append(make_table(hc_data[0], hc_data[1:], col_widths=[4*cm,4*cm,9.2*cm]))
    items.append(sp(6))

    # Developmental Milestones
    items.append(sub_header("Developmental Milestones", TEAL))
    items.append(sp(4))
    dm_headers = [b("Age"), b("Gross Motor"), b("Fine Motor"), b("Language"), b("Social")]
    dm_rows = [
        ["3 mo", "Head at 90°", "Hands open", "Coos", "Social smile"],
        ["6 mo", "Sits with support", "Palmar grasp", "Babbles", "Stranger anxiety"],
        ["9 mo", "Stands w/ support", "Pincer (immature)", "Mama/Dada (nonsense)", "Peek-a-boo"],
        ["12 mo", "Walks w/ support", "Mature pincer", "1-2 meaningful words", "Waves bye-bye"],
        ["18 mo", "Walks alone", "Scribbles", "8-10 words", "Parallel play"],
        ["2 yr", "Runs, stairs", "Builds 6 blocks", "2-word sentences", "Possessive (mine)"],
        ["3 yr", "Tricycle", "Copies circle", "3-word sentences", "Group play"],
        ["4 yr", "Hops 1 foot", "Copies cross (+)", "Tells stories", "Cooperative play"],
        ["5 yr", "Skips", "Copies triangle", "Complete sentences", "Follows rules"],
    ]
    items.append(make_table(dm_headers, dm_rows,
                 col_widths=[1.8*cm, 3.6*cm, 3.5*cm, 4.3*cm, 4*cm]))
    items.append(sp(6))

    # Dentition + Theories side by side
    left_data = [
        [Paragraph(b("Dentition"), S["sub_heading"])],
        [bullet("Primary teeth start: 6 months (lower central incisors)")],
        [bullet(f"Rule: No. of teeth = Age(months) {teal_t('- 6')} (up to 2 yrs)")],
        [bullet("Total primary teeth: 20")],
        [bullet("Permanent teeth start: 6 years (1st molar or lower central incisor)")],
        [bullet("Total permanent teeth: 32")],
    ]
    right_data = [
        [Paragraph(b("Developmental Theories"), S["sub_heading"])],
        [Paragraph(f"{b('Freud')}: Oral→Anal→Phallic→Latency→Genital", S["body"])],
        [Paragraph(f"{b('Erikson')}: Trust vs Mistrust (0-1y), Autonomy vs Shame (1-3y), Initiative vs Guilt (3-6y)", S["body"])],
        [Paragraph(f"{b('Piaget')}: Sensorimotor(0-2y) → Preoperational(2-7y) → Concrete Operational(7-11y) → Formal Operational(11y+)", S["body"])],
    ]
    lt = Table(left_data, colWidths=[8.4*cm])
    rt = Table(right_data, colWidths=[8.4*cm])
    combined = Table([[lt, rt]], colWidths=[8.6*cm, 8.6*cm])
    combined.setStyle(TableStyle([("VALIGN",(0,0),(-1,-1),"TOP")]))
    items.append(combined)
    items.append(sp(6))

    # Key viva points
    items.append(info_box(
        f"{red('KEY VIVA POINTS:')} Object permanence = 9 months | "
        f"Child says 'No' (negativism) = 18 months | "
        f"Anterior fontanelle bulges in {red('meningitis/hydrocephalus')}, "
        f"sunken in {red('dehydration')} | "
        f"Peak height velocity: Girls Tanner 2-3, Boys Tanner 4",
        bg=LIGHT_ORANGE, border=ORANGE
    ))
    return items


def topic2():
    """Nutrition"""
    items = []
    items.append(section_header("NUTRITION", colors.HexColor("#00695c"), "2"))
    items.append(sp(6))

    items.append(sub_header("Breastfeeding", TEAL))
    items.append(sp(4))
    items.append(bullet(f"{b('Exclusive breastfeeding')}: 0-6 months | Continue up to 2 years with complementary feeds"))
    items.append(bullet(f"{b('Colostrum')} (1st 3-5 days): Rich in IgA, lactoferrin, leukocytes, proteins, Vitamin A"))
    items.append(bullet(f"Benefits: Anti-infective, anti-allergic, ↑IQ, bonding, protects against SIDS, otitis media"))
    items.append(bullet(f"{red('Contraindications')}: HIV (resource-rich), active TB (untreated), galactosemia, maternal chemotherapy"))
    items.append(sp(6))

    items.append(sub_header("Weaning / Complementary Feeding", TEAL))
    items.append(sp(4))
    items.append(bullet("Start at 6 months | First foods: semi-solid (khichdi, rice, dal)"))
    items.append(bullet("Sequence: Cereals → Vegetables → Fruits → Non-veg"))
    items.append(bullet("By 1 year: Family foods | Never introduce cow's milk before 1 year"))
    items.append(sp(6))

    items.append(sub_header("Protein Energy Malnutrition (PEM) — Comparison", TEAL))
    items.append(sp(4))
    pem_headers = [b("Feature"), b("Kwashiorkor"), b("Marasmus")]
    pem_rows = [
        ["Timing", "Post-weaning (1-3 yr)", "Early infancy"],
        ["Cause", "Protein deficiency", "Calorie + Protein deficiency"],
        ["Edema", red("Present (pitting)"), "Absent"],
        ["Appearance", "'Moon face', pot belly", "'Old man' look, baggy pants"],
        ["Skin", "Flaky paint dermatosis", "Wrinkled, no subcutaneous fat"],
        ["Hair", "Flag sign, depigmented, pluckable", "Sparse, thin"],
        ["Appetite", "Poor", grn("Good (ravenous)")],
        ["Fatty liver", "Present", "Absent"],
        ["Wt for age", ">60% expected", "<60% expected"],
    ]
    items.append(make_table(pem_headers, pem_rows, col_widths=[4.5*cm, 6.3*cm, 6.3*cm]))
    items.append(sp(6))

    items.append(sub_header("Vitamin Deficiencies", TEAL))
    items.append(sp(4))
    vit_headers = [b("Vitamin"), b("Disease"), b("Key Signs / Findings")]
    vit_rows = [
        ["A (Retinol)", "Xerophthalmia", "Night blindness → Bitot's spots → Keratomalacia"],
        ["B1 (Thiamine)", "Beriberi", "Dry (neuropathy), Wet (cardiac), Infantile (heart failure)"],
        ["B2 (Riboflavin)", "Ariboflavinosis", "Angular stomatitis, cheilosis, glossitis, corneal vascularization"],
        ["B3 (Niacin)", "Pellagra", "3Ds: Dermatitis, Diarrhea, Dementia (+ Death = 4Ds)"],
        ["B9 (Folate)", "Megaloblastic anemia", "Neural tube defects (periconception deficiency)"],
        ["B12", "Megaloblastic anemia", "Subacute combined degeneration of spinal cord"],
        ["C (Ascorbic acid)", "Scurvy", red("Bleeding gums, corkscrew hair, perifollicular hemorrhage, Scorbutic rosary")],
        ["D (Calciferol)", "Rickets", red("Craniotabes, rachitic rosary, Harrison's sulcus, bowing of legs, widened metaphysis")],
        ["K", "Hemorrhagic disease", "Bleeding in newborn (day 1-7); treat with Vit K injection at birth"],
    ]
    items.append(make_table(vit_headers, vit_rows, col_widths=[3.5*cm, 4*cm, 9.7*cm]))
    items.append(sp(6))

    items.append(sub_header("Iron Deficiency Anemia", TEAL))
    items.append(sp(4))
    items.append(info_box(
        f"Most common nutritional deficiency in children | {b('Hypochromic microcytic anemia')} | "
        f"Serum ferritin {red('↓')} (earliest indicator) | Serum iron {red('↓')} | TIBC {grn('↑')} | "
        f"Blood smear: pencil cells, anisocytosis | "
        f"Treatment: {b('3-6 mg/kg/day')} elemental iron for 3-6 months",
        bg=LIGHT_TEAL, border=TEAL
    ))
    return items


def topic3():
    """Neonatology"""
    items = []
    items.append(section_header("NEONATOLOGY", colors.HexColor("#4527a0"), "3"))
    items.append(sp(6))

    items.append(sub_header("Key Definitions", TEAL))
    items.append(sp(4))
    def_data = [
        [b("Term"), b("Definition")],
        ["Neonate", "0-28 days of life"],
        ["Preterm", "< 37 weeks gestation"],
        ["Post-term", "> 42 weeks gestation"],
        ["LBW", "< 2500 g at birth"],
        ["VLBW", "< 1500 g at birth"],
        ["ELBW", "< 1000 g at birth"],
        ["SGA", "Weight < 10th percentile for gestational age"],
        ["LGA", "Weight > 90th percentile (e.g., IDM baby)"],
        ["IUGR", "Intrauterine growth restriction (asymmetric = placental; symmetric = TORCH)"],
    ]
    items.append(make_table(def_data[0], def_data[1:], col_widths=[3.5*cm, 13.7*cm]))
    items.append(sp(6))

    items.append(sub_header("APGAR Score (assess at 1 min and 5 min)", TEAL))
    items.append(sp(4))
    apgar_headers = [b("Sign"), b("Score 0"), b("Score 1"), b("Score 2")]
    apgar_rows = [
        ["Appearance", "Blue/pale all over", "Blue extremities", "Pink all over"],
        ["Pulse", "Absent", "< 100/min", "> 100/min"],
        ["Grimace", "None", "Grimace", "Cry / cough"],
        ["Activity (tone)", "Limp", "Some flexion", "Active motion"],
        ["Respiration", "Absent", "Weak / irregular", "Strong cry"],
    ]
    items.append(make_table(apgar_headers, apgar_rows, col_widths=[4.3*cm, 4.3*cm, 4.3*cm, 4.3*cm]))
    items.append(sp(3))
    items.append(info_box(
        f"7-10 = Normal | 4-6 = Moderate depression (stimulate) | {red('0-3 = Severe (resuscitate')})",
        bg=LIGHT_ORANGE, border=ORANGE
    ))
    items.append(sp(6))

    items.append(sub_header("Neonatal Jaundice", TEAL))
    items.append(sp(4))
    jaund_headers = [b("Feature"), b("Physiological"), b("Pathological")]
    jaund_rows = [
        ["Onset", "Day 2-3", red("Within 24 hours = always pathological")],
        ["Peak", "Day 4-5 (term)", "Varies"],
        ["Resolution", "Day 7-10 (term)\nDay 14 (preterm)", "Persists >14 days (term)"],
        ["Bilirubin rise", "< 5 mg/dL/day", "> 5 mg/dL/day"],
        ["Max bilirubin", "< 12 mg/dL (term)", "> 12 mg/dL (term)"],
        ["Cause", "Physiological hemolysis\n+ liver immaturity", "Rh/ABO incompatibility,\nG6PD, sepsis, TORCH"],
    ]
    items.append(make_table(jaund_headers, jaund_rows, col_widths=[4*cm, 6.5*cm, 6.7*cm]))
    items.append(sp(3))
    items.append(bullet(f"{b('Phototherapy')}: Indicated when bilirubin approaching exchange levels"))
    items.append(bullet(f"{b('Exchange transfusion')}: Bilirubin > 20 mg/dL (term); double volume (2×85 mL/kg)"))
    items.append(bullet(f"{b('Breast milk jaundice')}: Appears after day 5, lasts up to 3 months — benign, continue breastfeeding"))
    items.append(sp(6))

    items.append(sub_header("Respiratory Distress Syndrome (RDS / HMD)", TEAL))
    items.append(sp(4))
    items.append(bullet(f"Cause: {b('Surfactant deficiency')} — Type II pneumocytes mature after 34-35 weeks"))
    items.append(bullet(f"Signs: Grunting, tachypnea, subcostal retractions, cyanosis, flaring nares"))
    items.append(bullet(f"CXR: {b('Ground-glass opacity')}, air bronchograms, 'white-out' lungs"))
    items.append(bullet(f"Treatment: Surfactant replacement (intratracheal), CPAP, supplemental O2"))
    items.append(bullet(f"Prevention: {red('Antenatal betamethasone')} 24-34 weeks (accelerates lung maturity)"))
    items.append(sp(6))

    items.append(sub_header("Neonatal Sepsis", TEAL))
    items.append(sp(4))
    sep_headers = [b("Type"), b("Onset"), b("Organisms"), b("Treatment")]
    sep_rows = [
        ["Early-onset", "< 72 hours", "GBS, E. coli, Listeria\n(maternal organisms)", "Ampicillin + Gentamicin"],
        ["Late-onset", "> 72 hours", "Staph. aureus, Staph. epidermidis,\nKlebsiella, Candida", "Vancomycin + Aminoglycoside"],
    ]
    items.append(make_table(sep_headers, sep_rows, col_widths=[3*cm, 3*cm, 6.2*cm, 5*cm]))
    items.append(sp(3))
    items.append(bullet(f"Features: Temp instability, poor feeding, lethargy, bulging fontanelle, seizures, jaundice, apnea"))
    items.append(sp(6))

    items.append(sub_header("Birth Injuries & Other Key Topics", TEAL))
    items.append(sp(4))
    bi_data = [
        [b("Condition"), b("Key Features")],
        ["Erb's palsy (C5-C6)", "'Waiter's tip' — arm adducted, internally rotated, elbow extended, forearm pronated; absent Moro on affected side"],
        ["Klumpke's palsy (C8-T1)", "Claw hand; if sympathetics involved → Horner syndrome"],
        ["Hypoglycemia", "< 40 mg/dL (term); treat with 10% Dextrose 2 mL/kg IV bolus → infusion"],
        ["MAS", "Barrel chest, chemical pneumonitis; CXR: patchy opacities; complication: PPHN, pneumothorax"],
        ["Hypothermia", "Temp < 36.5°C; treat with KMC/skin-to-skin; cold stress → hypoglycemia + metabolic acidosis"],
    ]
    items.append(make_table(bi_data[0], bi_data[1:], col_widths=[4.5*cm, 12.7*cm]))
    return items


def topic4():
    """Immunization"""
    items = []
    items.append(section_header("IMMUNIZATION", colors.HexColor("#1b5e20"), "4"))
    items.append(sp(6))

    items.append(sub_header("National Immunization Schedule (India - UIP + IAP 2024)", TEAL))
    items.append(sp(4))
    imm_headers = [b("Age"), b("Vaccines")]
    imm_rows = [
        ["Birth", "BCG | OPV-0 (bOPV) | Hepatitis B-1"],
        ["6 weeks", "DTwP-1 / DTaP-1 | IPV-1 | Hep B-2 | Hib-1 | Rotavirus-1 | PCV-1"],
        ["10 weeks", "DTwP-2 | IPV-2 | Hib-2 | Rotavirus-2 | PCV-2"],
        ["14 weeks", "DTwP-3 | IPV-3 | Hib-3 | Rotavirus-3 | PCV-3"],
        ["6 months", "Hep B-3 | OPV-1"],
        ["9 months", "MMR-1 | OPV-2"],
        ["12 months", "Hep A-1 | Varicella-1"],
        ["15-18 months", "DTwP Booster-1 | IPV Booster | Hib Booster | MMR-2 | Varicella-2 | PCV Booster"],
        ["2 years", "Hep A-2 | Typhoid conjugate"],
        ["4-6 years", "DTwP Booster-2 | OPV Booster"],
        ["10-12 years", "Tdap / Td | HPV (girls, 2-dose series)"],
    ]
    items.append(make_table(imm_headers, imm_rows, col_widths=[3.5*cm, 13.7*cm]))
    items.append(sp(6))

    items.append(sub_header("Vaccine Types", TEAL))
    items.append(sp(4))
    vt_headers = [b("Type"), b("Examples")]
    vt_rows = [
        ["Live attenuated", "BCG, OPV, MMR, Varicella, Rotavirus, Yellow fever, JE (live)"],
        ["Killed / Inactivated", "IPV, Hep A, Rabies, Cholera, Influenza (TIV), Typhoid (Vi)"],
        ["Toxoid", "Diphtheria toxoid (DT), Tetanus toxoid (TT)"],
        ["Subunit / Conjugate", "Hep B (HBsAg), Hib (conjugate), PCV (conjugate), HPV, acellular Pertussis (aP)"],
    ]
    items.append(make_table(vt_headers, vt_rows, col_widths=[4.5*cm, 12.7*cm]))
    items.append(sp(6))

    items.append(sub_header("Cold Chain & Storage", TEAL))
    items.append(sp(4))
    cold_data = [
        [b("Storage Temp"), b("Vaccines")],
        ["-20°C (Freezer)", "OPV only"],
        ["2-8°C (Refrigerator)", "BCG, MMR, Varicella, IPV, DPT, Hep B, Hib, PCV, Rotavirus"],
        [red("DO NOT FREEZE"), "Hep B, DPT, IPV, Hib — freeze kills adsorbed vaccines (shake test detects)"],
    ]
    items.append(make_table(cold_data[0], cold_data[1:], col_widths=[4.5*cm, 12.7*cm]))
    items.append(sp(3))
    items.append(bullet(f"{b('Shake test')}: Shake frozen + non-frozen vials → if frozen, forms uniform flocculate vs normal vial"))
    items.append(sp(6))

    items.append(sub_header("BCG Vaccine", TEAL))
    items.append(sp(4))
    items.append(info_box(
        f"{b('Route')}: Intradermal (left deltoid) | {b('Dose')}: 0.05 mL (neonates), 0.1 mL (>1 month) | "
        f"{b('Age')}: At birth (up to 5 years if not given) | "
        f"PPD reaction appears {b('6-10 weeks')} after BCG | "
        f"{b('BCG scar')}: Appears 2-6 weeks post-vaccination | "
        f"{red('Contraindication')}: Symptomatic HIV, immunocompromised state",
        bg=LIGHT_TEAL, border=TEAL
    ))
    items.append(sp(6))

    items.append(sub_header("Contraindications to Vaccination", TEAL))
    items.append(sp(4))
    ci_headers = [b("TRUE Contraindications"), b("NOT Contraindications (Common Misconceptions)")]
    ci_rows = [
        ["Anaphylaxis to previous dose", "Mild fever / mild illness"],
        ["Encephalopathy after pertussis vaccine", "Current antibiotic use"],
        ["Severe combined immunodeficiency (for live vaccines)", "Breastfeeding"],
        ["Pregnancy (for live vaccines)", "Premature birth (vaccinate at chronological age)"],
        ["", "Family history of seizures or adverse reactions"],
    ]
    items.append(make_table(ci_headers, ci_rows, col_widths=[8.6*cm, 8.6*cm]))
    return items


def topic5():
    """Diseases of GIT"""
    items = []
    items.append(section_header("DISEASES OF GIT", ORANGE, "5"))
    items.append(sp(6))

    items.append(sub_header("Diarrhea — Classification & Management", TEAL))
    items.append(sp(4))
    items.append(bullet(f"{b('Acute')}: < 14 days | {b('Persistent')}: 14-30 days | {b('Chronic')}: > 30 days"))
    items.append(bullet(f"Most common cause: {red('Rotavirus')} (viral) | Most common bacterial: E. coli"))
    items.append(sp(4))

    deh_headers = [b("Sign"), b("No Dehydration"), b("Some Dehydration (5-10%)"), b("Severe (>10%)")]
    deh_rows = [
        ["Condition", "Well, alert", "Restless, irritable", "Lethargic, unconscious"],
        ["Eyes", "Normal", "Sunken", "Very sunken"],
        ["Tears", "Present", "Absent", "Absent"],
        ["Mouth/tongue", "Moist", "Dry", "Very dry"],
        ["Thirst", "Normal", "Thirsty, drinks eagerly", "Unable to drink"],
        ["Skin pinch", "Goes back quickly", "Goes back slowly", "Goes back very slowly (>2s)"],
        ["Plan", grn("Plan A"), orange_t("Plan B"), red("Plan C")],
    ]
    items.append(make_table(deh_headers, deh_rows, col_widths=[3*cm, 4.4*cm, 5*cm, 4.8*cm]))
    items.append(sp(4))
    items.append(info_box(
        f"{b('ORS composition (WHO 2002)')}: Na 75 | Cl 65 | Glucose 75 | K 20 | Citrate 10 mEq/L | Osmolarity 245 mOsm/L | "
        f"{b('Plan B')}: 75 mL/kg ORS over 4 hours | {b('Plan C')}: Ringer's Lactate 100 mL/kg (30 mL/kg fast + 70 mL/kg slow) | "
        f"{b('Zinc')}: 20 mg/day × 14 days (>6 months); 10 mg/day (<6 months) — reduces severity & recurrence",
        bg=LIGHT_TEAL, border=TEAL
    ))
    items.append(sp(6))

    items.append(sub_header("Intussusception", TEAL))
    items.append(sp(4))
    items.append(bullet(f"Age: Most common {b('3 months - 5 years')} | Peak: 6-18 months"))
    items.append(bullet(f"{b('Classic triad')}: Colicky abdominal pain + {red('red currant jelly stool')} + sausage-shaped mass (RUQ)"))
    items.append(bullet(f"Investigation: Ultrasound ({b('target/doughnut sign')}) → contrast enema (diagnostic + therapeutic)"))
    items.append(bullet(f"Treatment: Pneumatic/hydrostatic reduction; surgical if failed or peritonitis"))
    items.append(sp(6))

    items.append(sub_header("Other Important GIT Conditions", TEAL))
    items.append(sp(4))
    git_data = [
        [b("Condition"), b("Key Points")],
        ["Hirschsprung's Disease",
         f"Absent ganglion cells (Meissner's + Auerbach's plexus) in rectosigmoid | "
         f"Features: Delayed meconium (>48 hrs), constipation, abdominal distension | "
         f"Barium enema: narrow distal + dilated proximal | "
         f"{b('Gold standard')}: Rectal biopsy | Treatment: Surgical pull-through"],
        ["GERD",
         f"Physiological regurgitation vs pathological GERD | Alarm signs: poor weight gain, blood in stool, apnea | "
         f"Treatment: Positioning (upright 30 min after feed), thickened feeds, PPI if severe"],
        ["Celiac Disease",
         f"Gluten sensitivity (wheat, barley, rye) | Features: Chronic diarrhea, FTT, abdominal distension | "
         f"Screening: {b('Anti-tTG IgA')} | Gold standard: {b('Small bowel biopsy')} (villous atrophy) | "
         f"Treatment: Lifelong gluten-free diet"],
        ["Pyloric Stenosis",
         f"Males 4:1 | Age: 2-6 weeks | {b('Projectile non-bilious vomiting')} after feeds | "
         f"Olive-shaped mass epigastrium | Hypochloremic hypokalemic metabolic alkalosis | "
         f"USS: pyloric channel length >14mm, muscle thickness >4mm | Treatment: Ramstedt pyloromyotomy"],
        ["Appendicitis",
         f"Peak age: 10-12 years | Features: RIF pain, fever, vomiting, Rovsing's sign, Psoas sign | "
         f"Alvarado score | CT scan (gold standard for diagnosis in children) | "
         f"Treatment: Emergency appendicectomy"],
    ]
    items.append(make_table(git_data[0], git_data[1:], col_widths=[3.8*cm, 13.4*cm]))
    return items


def topic6():
    """Infections & Infestations"""
    items = []
    items.append(section_header("INFECTIONS & INFESTATIONS", RED_ACCENT, "6"))
    items.append(sp(6))

    items.append(sub_header("Viral Exanthems — Quick Comparison", TEAL))
    items.append(sp(4))
    exan_headers = [b("Disease"), b("Virus"), b("Incubation"), b("Pathognomonic / Key"), b("Rash")]
    exan_rows = [
        ["Measles", "Paramyxovirus", "10-14 days", red("Koplik's spots (buccal mucosa)"), "Maculopapular, cephalocaudal; 3Cs prodrome"],
        ["Rubella", "Togavirus", "14-21 days", "Forchheimer spots (soft palate)", "Pink maculopapular; post-auricular LN"],
        ["Chickenpox", "VZV", "14-21 days", "Pleomorphic: all stages simultaneously", "Macule→Papule→Vesicle→Crust (starry sky)"],
        ["Roseola", "HHV-6", "10-14 days", "Fever resolves → rash appears", "Rose-pink macules (trunk first)"],
        ["Scarlet fever", "GAS (Strep)", "2-5 days", "Strawberry tongue", "Sandpaper rash; Pastia's lines"],
        ["Hand-foot-mouth", "Coxsackievirus A16", "3-7 days", "Oral ulcers + vesicles on extremities", "Vesicles on palms/soles"],
    ]
    items.append(make_table(exan_headers, exan_rows, col_widths=[2.8*cm, 3*cm, 2.5*cm, 5*cm, 3.9*cm]))
    items.append(sp(3))
    items.append(info_box(
        f"{b('Measles complications')}: Pneumonia (most common cause of death), Encephalitis, Otitis media, "
        f"{red('SSPE')} (subacute sclerosing panencephalitis — 7-10 yrs later) | "
        f"{b('Chickenpox treatment')}: Acyclovir in immunocompromised/severe cases",
        bg=LIGHT_ORANGE, border=ORANGE
    ))
    items.append(sp(6))

    items.append(sub_header("Dengue Fever", TEAL))
    items.append(sp(4))
    items.append(bullet(f"Vector: {b('Aedes aegypti')} mosquito (day biter) | Flavivirus, 4 serotypes"))
    items.append(bullet(f"Classic: High fever + severe headache + {b('retroorbital pain')} + myalgia + arthralgia ('breakbone fever')"))
    items.append(bullet(f"{red('Warning signs')}: Abdominal pain, persistent vomiting, bleeding, hepatomegaly, rapid deterioration"))
    items.append(bullet(f"{b('DHF Criteria (all 4)')}: Fever + hemorrhagic manifestations + thrombocytopenia (<100,000) + plasma leakage (↑HCT ≥20%)"))
    items.append(bullet(f"Diagnosis: {b('NS1 antigen')} (day 1-5) | IgM/IgG after day 5 | CBC daily (monitor platelet/HCT)"))
    items.append(bullet(f"Treatment: Supportive — IV fluids, platelet transfusion if <10,000 or active bleeding"))
    items.append(sp(6))

    items.append(sub_header("Typhoid (Enteric Fever)", TEAL))
    items.append(sp(4))
    items.append(bullet(f"Organism: {b('Salmonella typhi')} | Feco-oral route | Incubation 10-14 days"))
    items.append(bullet(f"Features: Stepladder fever, relative bradycardia, rose spots (anterior chest), splenomegaly"))
    items.append(bullet(f"Week 1 → Blood culture (best) | Week 2-3 → Widal (TO≥1:160, TH≥1:160) | Week 3-4 → Stool/urine culture"))
    items.append(bullet(f"Treatment: {b('Azithromycin')} (1st line uncomplicated) | Ceftriaxone (IV, severe) | Ciprofloxacin (adults)"))
    items.append(sp(6))

    items.append(sub_header("Worm Infestations", TEAL))
    items.append(sp(4))
    worm_headers = [b("Parasite"), b("Route of Entry"), b("Key Features"), b("Treatment")]
    worm_rows = [
        ["Ascaris lumbricoides", "Feco-oral (eggs)", "Loeffler's syndrome; intestinal obstruction (most common cause in children)", "Albendazole 400 mg single dose"],
        ["Hookworm", "Skin penetration (larvae)", "Iron deficiency anemia; cutaneous larva migrans", "Albendazole + iron supplementation"],
        ["Enterobius (Pinworm)", "Feco-oral", "Perianal itching at night; Scotch tape test", "Mebendazole 100 mg × 1 (repeat after 2 weeks)"],
        ["Giardia lamblia", "Feco-oral (cysts)", "Frothy foul-smelling stool; malabsorption; cysts in stool", "Metronidazole 5 days"],
        ["Tapeworm (Taenia)", "Undercooked meat", "Pork → cysticercosis (CNS); Beef → intestinal only", "Praziquantel"],
    ]
    items.append(make_table(worm_headers, worm_rows, col_widths=[3.2*cm, 3.2*cm, 6.5*cm, 4.3*cm]))
    items.append(sp(6))

    items.append(sub_header("Malaria & Kala-azar", TEAL))
    items.append(sp(4))
    mk_data = [
        [b("Feature"), b("Malaria"), b("Kala-azar (VL)")],
        ["Organism", "Plasmodium spp.", "Leishmania donovani"],
        ["Vector", "Anopheles mosquito (female)", "Phlebotomus sandfly"],
        ["Fever pattern", "Tertian (48h) P.vivax; Quartan (72h) P.malariae", "Prolonged, irregular"],
        ["Splenomegaly", "Moderate", red("Massive (hallmark)")],
        ["Skin", "Normal", "Darkening (post-kala-azar)"],
        ["Diagnosis", "Peripheral smear (thick+thin)", "rK39 strip; bone marrow/splenic aspirate (gold standard)"],
        ["Treatment", "Chloroquine (P.vivax); Artesunate (P.falciparum)", "Liposomal Amphotericin B (India 1st line)"],
    ]
    items.append(make_table(mk_data[0], mk_data[1:], col_widths=[3.5*cm, 6.8*cm, 6.9*cm]))
    return items


def topic7():
    """Adolescent Medicine"""
    items = []
    items.append(section_header("ADOLESCENT MEDICINE", colors.HexColor("#880e4f"), "7"))
    items.append(sp(6))

    items.append(sub_header("Puberty — Tanner Stages", TEAL))
    items.append(sp(4))
    t_headers = [b("Stage"), b("Girls (onset 8-13 yrs)"), b("Boys (onset 9-14 yrs)")]
    t_rows = [
        ["Stage 1", "Prepubertal", "Prepubertal"],
        ["Stage 2", red("Breast budding (FIRST sign)") + "\nPublic hair begins (villous)",
         red("Testicular enlargement >4 mL (FIRST sign)") + "\nPublic hair begins"],
        ["Stage 3", "Breast enlargement; pubic hair darkens/coarsens", "Penile elongation; pubic hair darkens"],
        ["Stage 4", "Secondary areolar mound; axillary hair; menarche", "Darkening of scrotum; increased penile width"],
        ["Stage 5", "Adult breast configuration", "Adult genitalia size"],
    ]
    items.append(make_table(t_headers, t_rows, col_widths=[2.2*cm, 7.5*cm, 7.5*cm]))
    items.append(sp(3))
    items.append(info_box(
        f"{b('Menarche')}: Occurs at Tanner stage 3-4 (1-3 years after breast budding) | "
        f"{b('Peak height velocity')}: Girls = Tanner 2-3 | Boys = Tanner 4 | "
        f"{b('Girls height increase')}: ~6-10 cm/year at PHV | {b('Boys')}: ~8-14 cm/year",
        bg=LIGHT_BLUE, border=TEAL
    ))
    items.append(sp(6))

    items.append(sub_header("Precocious Puberty", TEAL))
    items.append(sp(4))
    pp_headers = [b("Type"), b("Definition"), b("Causes"), b("Treatment")]
    pp_rows = [
        ["Central (GnRH-dependent)",
         "Girls < 8 yrs\nBoys < 9 yrs",
         "Idiopathic (girls 80%)\nCNS tumors, hydrocephalus\nHypothyroidism",
         "GnRH analogues\n(leuprolide)"],
        ["Peripheral (GnRH-independent)",
         "Same age criteria",
         "McCune-Albright, CAH\nGonadal/adrenal tumors\nExogenous estrogen",
         "Treat underlying cause"],
    ]
    items.append(make_table(pp_headers, pp_rows, col_widths=[3.8*cm, 3*cm, 6*cm, 4.4*cm]))
    items.append(sp(6))

    items.append(sub_header("Key Adolescent Conditions", TEAL))
    items.append(sp(4))
    ac_data = [
        [b("Condition"), b("Key Points")],
        ["Acne vulgaris",
         "Androgen-induced ↑sebum; Propionibacterium acnes | Comedonal: topical retinoids | "
         "Mild-moderate: benzoyl peroxide ± topical antibiotics | Severe/nodular: oral isotretinoin"],
        ["Anorexia Nervosa",
         f"{red('< 85% ideal body weight')} | Body dysmorphia | Amenorrhea | Lanugo hair | "
         f"Bradycardia, hypotension, electrolyte imbalance | Russell's sign (knuckle scarring in purging type)"],
        ["Bulimia Nervosa",
         "Binge-purge cycles | Normal/overweight | Hypokalemia, metabolic alkalosis | "
         "Dental erosion, parotid enlargement | Treatment: CBT + SSRI (fluoxetine)"],
        ["PCOS",
         "Rotterdam criteria (2/3): Oligo-anovulation + hyperandrogenism + polycystic ovaries | "
         "Treatment: OCP + metformin (insulin resistance); clomiphene (infertility)"],
        ["Gynecomastia",
         "Common in Tanner stage 3-4 boys (physiological) | Unilateral subareolar disc | "
         "Resolves in 1-2 years | Pathological: Klinefelter's, drugs, liver disease"],
    ]
    items.append(make_table(ac_data[0], ac_data[1:], col_widths=[3.5*cm, 13.7*cm]))
    items.append(sp(6))

    items.append(info_box(
        f"{b('HEADS assessment')}: Home, Education/Employment, Activities, Drugs, Sexuality, Suicide/depression | "
        f"{b('HPV vaccine')}: 2-dose (9-14 yrs) or 3-dose (15+ yrs); protects against HPV 6,11,16,18 | "
        f"{b('Iron requirement in adolescent girls')}: 32.7 mg/day (menstruating) | "
        f"{red('Red flags')}: BMI < 17.5 (anorexia), suicidal ideation, substance use",
        bg=LIGHT_ORANGE, border=ORANGE
    ))
    return items


def topic8():
    """Respiratory System"""
    items = []
    items.append(section_header("RESPIRATORY SYSTEM", colors.HexColor("#01579b"), "8"))
    items.append(sp(6))

    items.append(sub_header("WHO Pneumonia Classification (IMCI)", TEAL))
    items.append(sp(4))
    pn_headers = [b("Age Group"), b("Fast Breathing Threshold"), b("Classification"), b("Management")]
    pn_rows = [
        ["< 2 months", "> 60 breaths/min", "Severe disease — chest indrawing or fast breathing", "Refer + Ampicillin + Gentamicin"],
        ["2-12 months", "> 50 breaths/min", "Pneumonia (fast breathing only)", "Amoxicillin 3 days (outpatient)"],
        ["1-5 years", "> 40 breaths/min", "Severe pneumonia (chest indrawing + fast breathing)", "IV antibiotics + O2 (admit)"],
        ["", "", red("Very severe (cyanosis, unable to drink, convulsions)"), red("Urgent referral / ICU")],
    ]
    items.append(make_table(pn_headers, pn_rows, col_widths=[3*cm, 4*cm, 5.5*cm, 4.7*cm]))
    items.append(sp(3))
    items.append(bullet(f"{b('Common organisms by age')}: < 3 months: GBS/Chlamydia | 3m-5y: S. pneumoniae, H. influenzae | > 5y: Mycoplasma, S. pneumoniae"))
    items.append(sp(6))

    items.append(sub_header("Bronchiolitis vs Asthma vs Croup — Comparison", TEAL))
    items.append(sp(4))
    bac_headers = [b("Feature"), b("Bronchiolitis"), b("Asthma"), b("Croup")]
    bac_rows = [
        ["Peak age", "< 2 years", "Any age (often 2-5 yrs)", "6 months - 3 years"],
        ["Cause", red("RSV (most common)"), "Allergic, multifactorial", "Parainfluenza virus"],
        ["Key symptom", "Wheeze + hyperinflation", "Wheeze + cough at night", red("Barking cough + stridor")"],
        ["CXR", "Hyperinflation, peribronchial thickening", "Hyperinflation (chronic)", red("'Steeple sign'")],
        ["Treatment", "Supportive, O2, hydration", "SABA → ICS → ICS+LABA", "Dexamethasone + nebulized epinephrine (severe)"],
        ["Hospital indication", "O2 sat < 92%, poor feeding", "No improvement with SABA", "Stridor at rest"],
    ]
    items.append(make_table(bac_headers, bac_rows, col_widths=[3*cm, 4.5*cm, 4.8*cm, 4.9*cm]))
    items.append(sp(6))

    items.append(sub_header("Tuberculosis in Children", TEAL))
    items.append(sp(4))
    items.append(bullet(f"{b('Mantoux (Tuberculin test)')}: Read at 48-72 hrs | Induration (not redness):"))
    items.append(bullet(f"≥ {b('5 mm')}: HIV+, close contact, immunocompromised, CXR abnormality"))
    items.append(bullet(f"≥ {b('10 mm')}: Children < 5 yrs, immigrants from high-prevalence areas, general population"))
    items.append(bullet(f"≥ {b('15 mm')}: No known risk factors"))
    items.append(sp(3))
    tb_data = [
        [b("Type"), b("CXR / Features")],
        ["Primary complex", "Ghon focus (parenchymal) + ipsilateral hilar LN = Ranke complex"],
        ["Progressive primary TB", "Extensive pneumonia, lobar consolidation in children"],
        ["Miliary TB", red("'Millet seed' opacities (1-2 mm) uniformly distributed | Hematogenous spread")],
        ["TB meningitis", "Most dangerous; complications: hydrocephalus, cranial nerve palsies"],
        ["Lymph node TB", "Most common extrapulmonary in children; cervical LN most frequent"],
    ]
    items.append(make_table(tb_data[0], tb_data[1:], col_widths=[4*cm, 13.2*cm]))
    items.append(sp(3))
    items.append(info_box(
        f"{b('RNTCP Treatment')} — New case: {b('2HRZE / 4HR')} | "
        f"H=Isoniazid | R=Rifampicin | Z=Pyrazinamide | E=Ethambutol | "
        f"{b('Side effects')}: INH → peripheral neuropathy (give B6) | Rifampicin → hepatotoxicity, orange urine | "
        f"Ethambutol → {red('optic neuritis')} (avoid < 5 yrs or check vision regularly)",
        bg=LIGHT_TEAL, border=TEAL
    ))
    items.append(sp(6))

    items.append(sub_header("Whooping Cough (Pertussis)", TEAL))
    items.append(sp(4))
    items.append(bullet(f"Organism: {b('Bordetella pertussis')} | Highly contagious; infants <6 months most vulnerable"))
    items.append(bullet(f"Stages: {b('Catarrhal')} (1-2 wks, most infectious; mimics URTI) → {b('Paroxysmal')} (4-6 wks; inspiratory 'whoop', post-tussive vomiting) → {b('Convalescent')} (weeks)"))
    items.append(bullet(f"Diagnosis: Nasopharyngeal swab culture (gold standard); PCR | Lymphocytosis on CBC"))
    items.append(bullet(f"Treatment: {b('Azithromycin')} (drug of choice); erythromycin alternative | Post-exposure prophylaxis for close contacts"))
    return items


def topic9():
    """Haematological Disorders"""
    items = []
    items.append(section_header("HAEMATOLOGICAL DISORDERS", colors.HexColor("#b71c1c"), "9"))
    items.append(sp(6))

    items.append(sub_header("Anemia — Classification by MCV", TEAL))
    items.append(sp(4))
    anemia_headers = [b("Type"), b("MCV"), b("Causes"), b("Key Finding")]
    anemia_rows = [
        ["Microcytic hypochromic", "< 80 fL", "Iron deficiency, Thalassemia, lead poisoning, sideroblastic", "Serum ferritin ↓ (IDA); HbA2 ↑ (Beta thal minor)"],
        ["Normocytic normochromic", "80-100 fL", "Acute blood loss, hemolysis, aplastic anemia, CKD", "Reticulocyte count differentiates"],
        ["Macrocytic", "> 100 fL", "Folate/B12 deficiency, hypothyroidism, liver disease", "Hypersegmented neutrophils; megaloblasts"],
    ]
    items.append(make_table(anemia_headers, anemia_rows, col_widths=[3.8*cm, 2*cm, 6.5*cm, 4.9*cm]))
    items.append(sp(6))

    items.append(sub_header("Thalassemia — Overview", TEAL))
    items.append(sp(4))
    thal_headers = [b("Feature"), b("Beta Thal Minor"), b("Beta Thal Major (Cooley's)"), b("Alpha Thal Major (Hydrops)")]
    thal_rows = [
        ["Inheritance", "1 beta gene mutation", "Both beta genes mutated", "All 4 alpha genes deleted"],
        ["Hb electrophoresis", "HbA2 > 3.5% ↑↑", "HbF ↑↑, HbA absent", "Only Hb Barts (γ4)"],
        ["Clinical", "Mild anemia, asymptomatic", red("Severe: chipmunk face, frontal bossing, hepatosplenomegaly"), red("Hydrops fetalis, stillbirth")],
        ["Transfusion need", "None / occasional", "Regular (every 2-4 wks)", "Usually fatal in utero"],
        ["Treatment", "Folic acid", "Transfusions + Desferrioxamine\nBone marrow transplant (curative)", "Intrauterine transfusion / termination"],
    ]
    items.append(make_table(thal_headers, thal_rows, col_widths=[3*cm, 3.7*cm, 5.5*cm, 5*cm]))
    items.append(sp(6))

    items.append(sub_header("Sickle Cell Disease", TEAL))
    items.append(sp(4))
    items.append(bullet(f"Mutation: {b('Glu→Val')} at position 6 of beta chain | HbS polymerizes under low O2/dehydration/acidosis"))
    scd_data = [
        [b("Crisis Type"), b("Trigger"), b("Features")],
        ["Vaso-occlusive (most common)", "Dehydration, cold, infection", "Painful crises — bones, chest, abdomen; dactylitis in infants (hand-foot syndrome)"],
        ["Aplastic crisis", red("Parvovirus B19"), "Sudden Hb drop; bone marrow suppression"],
        ["Splenic sequestration", "Sudden red cell pooling", "Acute splenomegaly; hypovolemic shock (emergency!)"],
        ["Hemolytic crisis", "Infection, oxidant drugs", "↑ jaundice, ↓ Hb, ↑ reticulocytes"],
    ]
    items.append(make_table(scd_data[0], scd_data[1:], col_widths=[4.5*cm, 4*cm, 8.7*cm]))
    items.append(sp(3))
    items.append(bullet(f"Features: Autosplenectomy by age 5 → susceptible to encapsulated organisms | Stroke | Acute chest syndrome"))
    items.append(bullet(f"Treatment: {b('Hydroxyurea')} (↑HbF) | Penicillin prophylaxis | Transfusions | BMT (curative)"))
    items.append(sp(6))

    items.append(sub_header("Hemophilia vs ITP vs ALL", TEAL))
    items.append(sp(4))
    bleed_headers = [b("Feature"), b("Hemophilia A/B"), b("ITP"), b("ALL")]
    bleed_rows = [
        ["Defect", "Factor VIII (A) / IX (B) deficiency", "Autoimmune platelet destruction", "Malignant lymphoblasts"],
        ["Inheritance", "X-linked recessive", "Acquired (post-viral)", "Sporadic (peak 2-5 yrs)"],
        ["Bleeding type", "Hemarthrosis, deep hematomas", "Petechiae, purpura, mucous membrane", "Petechiae + pallor + bone pain"],
        ["Platelets", "Normal", red("< 20,000/mm³"), "Low (bone marrow failure)"],
        ["PT/APTT", "APTT prolonged, PT normal", "Normal", "Normal or ↑"],
        ["Treatment", "Factor concentrate\n(VIII or IX)", "Observation (self-limiting)\nIVIG / Steroids if severe", "Vincristine + Prednisolone\n+ Asparaginase (induction)"],
    ]
    items.append(make_table(bleed_headers, bleed_rows, col_widths=[3*cm, 4.5*cm, 4.5*cm, 5.2*cm]))
    items.append(sp(3))
    items.append(info_box(
        f"{b('Hemophilia')}: Knee most common hemarthrosis joint | DDAVP raises factor VIII (mild hemophilia A) | "
        f"{b('ITP')}: NO hepatosplenomegaly; 80% resolve in 6 months spontaneously | "
        f"{b('ALL')}: Most common childhood cancer; 'starry sky' in Burkitt's (L3 FAB)",
        bg=LIGHT_ORANGE, border=ORANGE
    ))
    return items


def topic10():
    """Renal Disorders"""
    items = []
    items.append(section_header("RENAL DISORDERS", colors.HexColor("#004d40"), "10"))
    items.append(sp(6))

    items.append(sub_header("Nephrotic vs Nephritic Syndrome", TEAL))
    items.append(sp(4))
    ns_headers = [b("Feature"), b("Nephrotic Syndrome"), b("Nephritic Syndrome")]
    ns_rows = [
        ["Proteinuria", red("> 3.5 g/day (massive)"), "< 2 g/day (mild)"],
        ["Hematuria", "Absent / minimal", red("Present (cola-colored urine)")],
        ["Blood pressure", "Normal or low", red("Hypertension")],
        ["Edema", "Periorbital (morning) → anasarca", "Mild, periorbital"],
        ["Complement", "Normal (MCD) / ↓ in MPGN", red("↓ C3 in PSGN")],
        ["Albumin", red("< 2.5 g/dL"), "Normal"],
        ["Cholesterol", red("↑↑ (hypercholesterolemia)"), "Normal"],
        ["Most common cause (children)", "Minimal Change Disease (MCD)", "Post-Streptococcal GN (PSGN)"],
    ]
    items.append(make_table(ns_headers, ns_rows, col_widths=[4*cm, 6.5*cm, 6.7*cm]))
    items.append(sp(6))

    items.append(sub_header("Nephrotic Syndrome — Deep Dive", TEAL))
    items.append(sp(4))
    items.append(bullet(f"{b('Tetrad')}: Massive proteinuria + hypoalbuminemia + edema + hypercholesterolemia"))
    items.append(bullet(f"{b('Pathophysiology')}: ↓albumin → ↓oncotic pressure → fluid extravasation → edema → ↑aldosterone → Na/water retention"))
    items.append(bullet(f"{b('Complications')}: {red('Spontaneous bacterial peritonitis')} (S. pneumoniae most common) | VTE | Hypothyroidism | ↑infection risk"))
    items.append(bullet(f"{b('MCD histology')}: EM = fusion of foot processes (effacement); LM = normal; IF = negative"))
    items.append(bullet(f"{b('Treatment')}: Prednisolone 60 mg/m²/day × 4 weeks → 40 mg/m²/alternate day × 4 weeks"))
    items.append(bullet(f"Steroid-sensitive (85% in children) vs steroid-resistant (consider biopsy — FSGS, MPGN)"))
    items.append(sp(6))

    items.append(sub_header("Post-Streptococcal Glomerulonephritis (PSGN)", TEAL))
    items.append(sp(4))
    items.append(bullet(f"Follows GAS throat (1-3 weeks) or skin infection (3-6 weeks)"))
    items.append(bullet(f"Features: Hematuria (cola/smoky urine), hypertension, edema, oliguria"))
    items.append(bullet(f"Investigations: ↓C3, ↑ASO titer (throat) or Anti-DNase B (skin) | Urine: RBC casts"))
    items.append(bullet(f"EM: Subepithelial {red('humps')} | IF: Granular 'starry sky' IgG + C3"))
    items.append(bullet(f"Treatment: Supportive (antihypertensives, fluid/Na restriction, diuretics) | Penicillin to clear strep | Prognosis: Excellent in children"))
    items.append(sp(6))

    items.append(sub_header("UTI, HUS & Wilms' Tumor", TEAL))
    items.append(sp(4))
    misc_data = [
        [b("Condition"), b("Key Points")],
        ["UTI in Children",
         f"Most common organism: {b('E. coli')} (> 80%) | Boys: structural anomaly till proven otherwise | "
         f"Girls < 5 yrs after 1st UTI → MCUG + DMSA scan for VUR | "
         f"Diagnosis: Urine culture > 10⁵ CFU/mL | Treatment: Nitrofurantoin/TMP-SMX (lower UTI); IV cephalosporin (pyelonephritis)"],
        ["HUS (Hemolytic Uremic Syndrome)",
         f"{b('Triad')}: Microangiopathic hemolytic anemia + Thrombocytopenia + {red('AKI')} | "
         f"Cause: {b('E. coli O157:H7')} (post-diarrheal, most common in children) | "
         f"Most common cause of AKI in children | Treatment: Supportive; avoid antibiotics (↑Shiga toxin release); dialysis if needed"],
        ["Wilms' Tumor (Nephroblastoma)",
         f"Peak age: {b('3-4 years')} | Most common renal tumor in children | "
         f"Associations: WAGR syndrome (WT1), Beckwith-Wiedemann syndrome (WT2) | "
         f"{b('Smooth non-tender flank mass')} (does NOT cross midline unlike neuroblastoma) | "
         f"Investigation: USS + CT abdomen (no biopsy before surgery) | "
         f"Treatment: Nephrectomy + chemotherapy ± radiotherapy | Prognosis: Excellent (> 90% 5-yr survival)"],
        ["Vesicoureteral Reflux (VUR)",
         f"Reflux of urine from bladder into ureter/kidney | Graded I-V | "
         f"Risk: recurrent UTI → renal scarring → hypertension → CKD | "
         f"Diagnosis: MCUG (micturating cystourethrogram) | "
         f"Treatment: Prophylactic antibiotics (low grade); surgical correction (high grade)"],
    ]
    items.append(make_table(misc_data[0], misc_data[1:], col_widths=[3.8*cm, 13.4*cm]))
    return items


def quick_fire_page():
    """Quick-fire summary / exam tips page"""
    items = []
    items.append(section_header("QUICK-FIRE VIVA REFERENCE", colors.HexColor("#37474f"), "★"))
    items.append(sp(6))

    items.append(sub_header("'Most Common' — High-Yield Exam Facts", TEAL))
    items.append(sp(4))
    mc_data = [
        [b("Question"), b("Answer")],
        ["Most common cause of diarrhea in children", red("Rotavirus")],
        ["Most common childhood cancer", red("ALL (Acute Lymphoblastic Leukemia)")],
        ["Most common nephrotic syndrome in children", red("Minimal Change Disease (MCD)")],
        ["Most common cause of AKI in children", red("HUS (E. coli O157:H7)")],
        ["Most common cause of bronchiolitis", red("RSV (Respiratory Syncytial Virus)")],
        ["Most common worm causing intestinal obstruction", red("Ascaris lumbricoides")],
        ["Most common nutritional deficiency", red("Iron Deficiency Anemia")],
        ["Most common organism in UTI", red("E. coli (> 80%)")],
        ["Most common cause of death in measles", red("Pneumonia")],
        ["Most common extrapulmonary TB in children", red("Lymph node TB (cervical)")],
        ["Most common renal tumor in children", red("Wilms' Tumor (Nephroblastoma)")],
        ["Most common bleeding disorder in children", red("ITP")],
        ["First sign of puberty in girls", red("Breast budding (thelarche)")],
        ["First sign of puberty in boys", red("Testicular enlargement > 4 mL")],
        ["Most common cause of neonatal seizures", red("Hypoxic ischemic encephalopathy (HIE)")],
        ["Most common cause of meningitis in neonate (early)", red("GBS (Group B Streptococcus)")],
    ]
    items.append(make_table(mc_data[0], mc_data[1:], col_widths=[9.5*cm, 7.7*cm]))
    items.append(sp(6))

    items.append(sub_header("Mnemonics Collection", TEAL))
    items.append(sp(4))
    mn_data = [
        [b("Topic"), b("Mnemonic")],
        ["APGAR", "Appearance, Pulse, Grimace, Activity, Respiration"],
        ["Measles prodrome", "3 Cs — Cough, Coryza, Conjunctivitis"],
        ["Pellagra", "3 Ds — Dermatitis, Diarrhea, Dementia (+Death = 4Ds)"],
        ["Rickets X-ray", "CALLFBS — Craniotabes, Anterior fontanelle (large), Lordosis, Leg bowing, Fraying/cupping, Bossing (frontal), Swelling (wrists)"],
        ["Nephrotic tetrad", "HEAP — Hypoalbuminemia, Edema, Albuminuria (proteinuria), hypercholesterolaemia (Proteinemia)"],
        ["HUS triad", "HAK — Hemolytic anemia, thrombocytopenia (low plAtelets), Kidney (AKI)"],
        ["Immunization — live vaccines", "BCG, OPV, MMR, Varicella, Rotavirus — 'Born Of Mother Makes Vaccine Real'"],
        ["Kwashiorkor vs Marasmus", "Kwashiorkor = K = protein malnutrition; Marasmus = Massive calorie deficit"],
        ["Tanner staging", "Girls: Breast first | Boys: Testis first (both Stage 2)"],
        ["Sepsis early vs late", "Early = External (maternal) organisms GBS/E.coli | Late = Nosocomial Staph/Klebsiella"],
    ]
    items.append(make_table(mn_data[0], mn_data[1:], col_widths=[4.5*cm, 12.7*cm]))
    items.append(sp(6))

    items.append(sub_header("Key Differentials — Examiner Favorites", TEAL))
    items.append(sp(4))
    diff_pairs = [
        ("Physiological vs Pathological Jaundice", "Timing (day 2-3 vs <24h), level, cause, direct vs indirect"),
        ("Kwashiorkor vs Marasmus", "Edema, appearance, cause, fatty liver, appetite — see Topic 2 table"),
        ("Nephrotic vs Nephritic", "Proteinuria level, hematuria, BP, complement — see Topic 10 table"),
        ("Bronchiolitis vs Asthma", "Age, causative organism, CXR, response to bronchodilators"),
        ("MCD vs FSGS", "MCD: foot process effacement only; FSGS: focal segmental sclerosis on LM; MCD steroid-sensitive"),
        ("Hemophilia A vs B", "Factor VIII vs IX; both X-linked; both have prolonged APTT + normal PT"),
        ("Intussusception vs Appendicitis", "Intussusception: younger child, currant jelly stool, RUQ mass; Appendicitis: older, RIF pain, Rovsing's sign"),
    ]
    for pair, detail in diff_pairs:
        items.append(bullet(f"{b(pair)}: {detail}"))

    items.append(sp(6))
    items.append(sub_header("Normal Pediatric Values — Quick Reference", TEAL))
    items.append(sp(4))
    nv_headers = [b("Parameter"), b("Value"), b("Parameter"), b("Value")]
    nv_rows = [
        ["HR Neonate", "120-160 bpm", "HR 1-5 yrs", "80-120 bpm"],
        ["RR Neonate", "40-60/min", "RR 1-5 yrs", "25-40/min"],
        ["BP Neonate (systolic)", "60-80 mmHg", "BP 5 yr", "90-110 systolic"],
        ["Hb at birth", "16-18 g/dL", "Hb 6 months", "~11 g/dL (nadir)"],
        ["WBC Neonates", "9,000-30,000", "WBC children", "5,000-15,000"],
        ["Platelets", "150,000-450,000", "Blood glucose (neonatal)", "40-100 mg/dL"],
        ["Serum sodium", "135-145 mEq/L", "Serum potassium", "3.5-5.5 mEq/L"],
        ["Normal weight gain (0-3 mo)", "25-30 g/day", "Normal weight gain (3-6 mo)", "20 g/day"],
    ]
    items.append(make_table(nv_headers, nv_rows, col_widths=[4*cm, 4.5*cm, 4*cm, 4.7*cm]))
    return items


# ══════════════════════════════════════════════════════════════════════════════
# MAIN BUILD
# ══════════════════════════════════════════════════════════════════════════════

def build_pdf():
    output_path = "/home/daytona/workspace/pediatrics-pdf/Pediatrics_Viva_Quick_Reference.pdf"

    doc = SimpleDocTemplate(
        output_path,
        pagesize=A4,
        leftMargin=1.2*cm,
        rightMargin=1.2*cm,
        topMargin=1.5*cm,
        bottomMargin=1.3*cm,
        title="Pediatrics Viva Quick Reference",
        author="Orris Medical"
    )

    story = []

    # Cover page (special callback)
    story += cover_page()
    story.append(PageBreak())

    # Topics
    topic_builders = [
        topic1, topic2, topic3, topic4, topic5,
        topic6, topic7, topic8, topic9, topic10,
        quick_fire_page
    ]

    for i, builder in enumerate(topic_builders):
        story += builder()
        if i < len(topic_builders) - 1:
            story.append(PageBreak())

    # Use cover callback for page 1, normal for rest
    page_counter = [0]

    def on_page_universal(canvas, doc):
        page_counter[0] += 1
        if page_counter[0] == 1:
            on_cover_page(canvas, doc)
        else:
            on_page(canvas, doc)

    doc.build(story, onFirstPage=on_page_universal, onLaterPages=on_page_universal)
    print(f"PDF created: {output_path}")
    return output_path

if __name__ == "__main__":
    build_pdf()

cd /home/daytona/workspace/pediatrics-pdf && python generate_pdf.py 2>&1

~/pediatrics-pdf/generate_pdf.py

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/pediatrics-pdf/generate_pdf.py'

cd /home/daytona/workspace/pediatrics-pdf && python generate_pdf.py 2>&1

ls -lh /home/daytona/workspace/pediatrics-pdf/Pediatrics_Viva_Quick_Reference.pd…