#!/usr/bin/env python3
"""
Generate BMC Adrenal Histology MCQ booklet + cheatsheet as a PDF
"""

import requests
from reportlab.lib.pagesizes import A4
from reportlab.lib import colors
from reportlab.lib.units import cm, mm
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.platypus import (SimpleDocTemplate, Paragraph, Spacer, Table,
                                 TableStyle, HRFlowable, PageBreak, Image, KeepTogether)
from reportlab.lib.enums import TA_LEFT, TA_CENTER, TA_JUSTIFY
from reportlab.pdfgen import canvas
from io import BytesIO
import os

# ── Download the key histology image ──────────────────────────────────────────
IMG_URL = "https://cdn.orris.care/cdss_images/0c4c2326a1400230e281d4aed4e036265015d91f4848fba8fe55309c68d0aba9.png"
img_path = "/home/daytona/workspace/adrenal-histology-mcq/adrenal_histo.png"
if not os.path.exists(img_path):
    r = requests.get(IMG_URL, timeout=30)
    with open(img_path, "wb") as f:
        f.write(r.content)
    print("Image downloaded")
else:
    print("Image already present")

# ── Color palette ─────────────────────────────────────────────────────────────
TEAL      = colors.HexColor("#006D77")
ORANGE    = colors.HexColor("#E29578")
LIGHT_BG  = colors.HexColor("#EDF6F9")
RED       = colors.HexColor("#C1121F")
GREEN     = colors.HexColor("#2D6A4F")
YELLOW_BG = colors.HexColor("#FFF3CD")
PINK_BG   = colors.HexColor("#FFE8E8")
BLUE_BG   = colors.HexColor("#E8F4FD")
DARK_GRAY = colors.HexColor("#2B2D42")

styles = getSampleStyleSheet()

# Custom styles
title_style = ParagraphStyle("Title", parent=styles["Title"],
    fontName="Helvetica-Bold", fontSize=22, textColor=TEAL,
    spaceAfter=4, alignment=TA_CENTER)

subtitle_style = ParagraphStyle("Subtitle", parent=styles["Normal"],
    fontName="Helvetica", fontSize=11, textColor=DARK_GRAY,
    spaceAfter=2, alignment=TA_CENTER)

section_head = ParagraphStyle("SH", parent=styles["Heading1"],
    fontName="Helvetica-Bold", fontSize=14, textColor=colors.white,
    backColor=TEAL, spaceBefore=12, spaceAfter=6,
    leftIndent=-6, rightIndent=-6, borderPad=6)

q_style = ParagraphStyle("Q", parent=styles["Normal"],
    fontName="Helvetica-Bold", fontSize=11, textColor=DARK_GRAY,
    spaceBefore=8, spaceAfter=2, leading=15)

opt_style = ParagraphStyle("Opt", parent=styles["Normal"],
    fontName="Helvetica", fontSize=10.5, textColor=DARK_GRAY,
    leftIndent=16, spaceAfter=1, leading=14)

ans_style = ParagraphStyle("Ans", parent=styles["Normal"],
    fontName="Helvetica-Bold", fontSize=10.5, textColor=GREEN,
    leftIndent=16, spaceAfter=1)

explain_style = ParagraphStyle("Exp", parent=styles["Normal"],
    fontName="Helvetica", fontSize=10, textColor=DARK_GRAY,
    leftIndent=16, spaceBefore=3, spaceAfter=4, leading=14)

hint_style = ParagraphStyle("Hint", parent=styles["Normal"],
    fontName="Helvetica-Oblique", fontSize=9.5, textColor=colors.HexColor("#7B2D8B"),
    leftIndent=16, spaceAfter=2, backColor=YELLOW_BG, borderPad=4)

year_style = ParagraphStyle("Year", parent=styles["Normal"],
    fontName="Helvetica-Bold", fontSize=9, textColor=RED,
    leftIndent=16, spaceAfter=4)

cheat_head = ParagraphStyle("CH", parent=styles["Heading2"],
    fontName="Helvetica-Bold", fontSize=13, textColor=TEAL,
    spaceBefore=8, spaceAfter=4)

cheat_body = ParagraphStyle("CB", parent=styles["Normal"],
    fontName="Helvetica", fontSize=9.5, textColor=DARK_GRAY,
    spaceAfter=2, leading=13)

bold_cell = ParagraphStyle("BC", parent=styles["Normal"],
    fontName="Helvetica-Bold", fontSize=9, textColor=colors.white)

norm_cell = ParagraphStyle("NC", parent=styles["Normal"],
    fontName="Helvetica", fontSize=9, textColor=DARK_GRAY)

# ── MCQ DATA ──────────────────────────────────────────────────────────────────
mcqs = [
  {
    "n": 1,
    "q": "Q1. Which embryological layer gives rise to the adrenal CORTEX?",
    "opts": ["A. Neural crest (neuroectoderm)", "B. Mesoderm", "C. Endoderm", "D. Surface ectoderm"],
    "ans": "B",
    "correct": "B. Mesoderm",
    "exp": "The adrenal cortex develops from mesoderm (specifically the intermediate mesoderm/urogenital ridge). "
           "The adrenal medulla arises from neural crest cells. This difference in embryological origin explains "
           "why cortex secretes steroids while medulla secretes catecholamines.",
    "hint": "Mnemonic: 'Cortex = Mesoderm, Medulla = Neural crest'. Think: Mesoderm = Middle, Cortex = outer ring.",
    "year": "Appeared in BMC past papers 2021, 2022 - HIGH YIELD (direct factual, appears almost every year)",
    "imp": 5
  },
  {
    "n": 2,
    "q": "Q2. The adrenal medulla is best described as modified:",
    "opts": ["A. Parasympathetic preganglionic neurons", "B. Sympathetic preganglionic neurons",
             "C. Sympathetic postganglionic neurons", "D. Parasympathetic postganglionic neurons"],
    "ans": "C",
    "correct": "C. Sympathetic postganglionic neurons",
    "exp": "Chromaffin cells of the adrenal medulla are derived from neural crest and are considered modified "
           "sympathetic POST-ganglionic neurons that lack axons/dendrites and function as secretory cells. "
           "They are innervated by PRE-ganglionic sympathetic fibers - the tricky distractor is option B "
           "which describes what innervates them, NOT what they ARE.",
    "hint": "Trick: Chromaffin cells are INNERVATED by preganglionic fibers, but they themselves ARE modified postganglionic neurons.",
    "year": "Classic question type - BMC 2020, 2021. Importance: ★★★★★",
    "imp": 5
  },
  {
    "n": 3,
    "q": "Q3. A researcher examines adrenal cortex histology. She identifies a zone with cells arranged in "
         "arched cords/clusters (glomeruli), comprising ~15% of the cortex. What hormone does this zone produce?",
    "opts": ["A. Cortisol (glucocorticoid)", "B. DHEA (androgen)", "C. Aldosterone (mineralocorticoid)",
             "D. Epinephrine (catecholamine)"],
    "ans": "C",
    "correct": "C. Aldosterone (mineralocorticoid)",
    "exp": "Zona glomerulosa (ZG): immediately beneath capsule, 15% of cortex, cells in arched cords/oval clusters. "
           "Produces mineralocorticoids (aldosterone). Regulated by angiotensin II and K+ concentration - NOT ACTH. "
           "Mnemonic: 'Salt - Sugar - Sex' from outer to inner (Glomerulosa=Salt, Fasciculata=Sugar, Reticularis=Sex).",
    "hint": "Remember the rule of three: Glomerulosa=Salt (aldosterone), Fasciculata=Sugar (cortisol), Reticularis=Sex (androgens).",
    "year": "BMC 2019, 2020, 2022 - recurs every year. Identify zone by % size + cell arrangement.",
    "imp": 5
  },
  {
    "n": 4,
    "q": "Q4. The thickest zone of the adrenal cortex (65-80% of cortex), consisting of long radial cords of "
         "large vacuolated 'spongiocytes', produces primarily:",
    "opts": ["A. Aldosterone", "B. Androgens (DHEA)", "C. Cortisol (glucocorticoids)", "D. Catecholamines"],
    "ans": "C",
    "correct": "C. Cortisol (glucocorticoids)",
    "exp": "Zona fasciculata (ZF): thickest zone (65-80%), long radial cords 1-2 cells thick with sinusoidal capillaries. "
           "Cells are large, polyhedral with lipid-filled VACUOLATED cytoplasm = 'SPONGIOCYTES' (key histology term). "
           "Produces glucocorticoids (cortisol, corticosterone). Regulated by ACTH.",
    "hint": "'Fasciculata = Fascicles/bundles = radial cords; Spongiocytes = lipid vacuoles = Sugar/cortisol'",
    "year": "BMC 2020, 2021 - identify spongiocytes = ZF. Importance: ★★★★★",
    "imp": 5
  },
  {
    "n": 5,
    "q": "Q5. Zona reticularis cells are characterized by which distinguishing light microscopy feature compared "
         "to zona fasciculata cells?",
    "opts": ["A. More lipid droplets, paler cytoplasm",
             "B. Fewer lipid droplets, more lipofuscin, darker eosin staining",
             "C. Arranged in arched clusters with central nuclei",
             "D. Contain electron-dense catecholamine granules"],
    "ans": "B",
    "correct": "B. Fewer lipid droplets, more lipofuscin, darker eosin staining",
    "exp": "Zona reticularis (ZR): innermost cortical zone (~5%), irregular anastomosing cords with wide capillaries. "
           "Cells are SMALLER, contain FEWER lipid droplets and MORE lipofuscin pigment - therefore they stain "
           "MORE DARKLY with eosin than ZF. They produce weak androgens (DHEA). Stimulated by ACTH. "
           "Option D is a medullary (chromaffin cell) feature - a common distractor.",
    "hint": "Tricky: ZR cells look DARKER than ZF on H&E because LESS lipid = less vacuolation = more eosinophilia. More lipofuscin = darker.",
    "year": "High yield morphology distinction. BMC 2022 featured ZR vs ZF comparison. Importance: ★★★★",
    "imp": 4
  },
  {
    "n": 6,
    "q": "Q6. Which zone of the adrenal cortex is NOT regulated by ACTH?",
    "opts": ["A. Zona fasciculata only", "B. Zona reticularis only",
             "C. Both zona fasciculata and reticularis", "D. Zona glomerulosa"],
    "ans": "D",
    "correct": "D. Zona glomerulosa",
    "exp": "Zona glomerulosa secretion of aldosterone is controlled by the RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM "
           "(angiotensin II) and plasma K+ levels - NOT ACTH. Zona fasciculata AND zona reticularis are both "
           "regulated by ACTH with negative feedback from circulating glucocorticoids.",
    "hint": "Only glomerulosa is 'immune' to ACTH. Think: Salt balance (Na/K) is regulated by angiotensin II, not the pituitary.",
    "year": "Regulatory axis question - BMC 2021, 2023. Importance: ★★★★★",
    "imp": 5
  },
  {
    "n": 7,
    "q": "Q7. On electron microscopy, adrenal cortex cells are steroid-secreting cells. Which ultrastructural "
         "features distinguish them? (Select the BEST answer)",
    "opts": ["A. Abundant RER, Golgi stacks, and secretory vesicles",
             "B. Abundant SER, mitochondria with tubular cristae, lipid droplets",
             "C. Abundant SER, mitochondria with shelf-like (lamellar) cristae, dense granules",
             "D. Sparse SER, large nucleus with prominent nucleolus"],
    "ans": "B",
    "correct": "B. Abundant SER, mitochondria with tubular cristae, lipid droplets",
    "exp": "Classic triad of steroid-secreting cells on EM: (1) Profuse SER (for steroid synthesis), "
           "(2) Mitochondria with TUBULAR (not shelf-like) cristae - contain enzymes for cholesterol -> pregnenolone, "
           "(3) Lipid droplets (cholesterol storage). Option A describes protein-secreting cells (exocrine/endocrine peptide). "
           "Option C is wrong because mitochondria in steroid cells have TUBULAR not lamellar cristae.",
    "hint": "Key EM trick: Steroid cells = SER + TUBULAR cristae mitochondria. Protein cells = RER + lamellar cristae. The cristae type is the classic distractor.",
    "year": "EM feature question - BMC 2020, 2022 - ultra-high yield. Importance: ★★★★★",
    "imp": 5
  },
  {
    "n": 8,
    "q": "Q8. The adrenal gland is covered by a capsule of dense connective tissue and lacks which "
         "normally expected anatomical feature?",
    "opts": ["A. A blood supply", "B. A hilum", "C. A cortex", "D. Lymphatic drainage"],
    "ans": "B",
    "correct": "B. A hilum",
    "exp": "The adrenal gland notably LACKS A HILUM - this is a frequently tested fact from the lecture. "
           "The capsule sends thin trabeculae (septa) inward, and the stroma consists mainly of reticular fibers. "
           "The gland has abundant blood supply and lymphatics in the capsule and around larger vessels.",
    "hint": "Unique fact from the BMC lecture slide: 'The adrenal gland lacks a hilum.' Easy point!",
    "year": "Direct lecture fact - appeared in BMC short-answer 2021. Importance: ★★★",
    "imp": 3
  },
  {
    "n": 9,
    "q": "Q9. Chromaffin cells of the adrenal medulla are so named because they:",
    "opts": ["A. Stain intensely with eosin (eosinophilic)",
             "B. React with chromate salts by oxidation and polymerization of stored catecholamines",
             "C. Are derived from chromatin in the neural tube",
             "D. Stain purple with hematoxylin"],
    "ans": "B",
    "correct": "B. React with chromate salts by oxidation and polymerization of stored catecholamines",
    "exp": "The 'chromaffin reaction' involves oxidation and polymerization of catecholamines (epinephrine/norepinephrine) "
           "when exposed to chromate salts - giving a brown staining reaction. Chromaffin cells are part of the APUD "
           "(Amine Precursor Uptake and Decarboxylation) system. The name has NOTHING to do with chromatin or hematoxylin.",
    "hint": "Chrom-affin = chromate-affinity. The reaction colors catecholamine granules brown. Option A and D are wrong staining claims.",
    "year": "Etymology/mechanism question - BMC 2022. Importance: ★★★★",
    "imp": 4
  },
  {
    "n": 10,
    "q": "Q10. On EM, chromaffin cells contain electron-dense secretory granules 150-350 nm in diameter. "
         "Which statement about epinephrine vs norepinephrine secreting granules is CORRECT?",
    "opts": ["A. Epinephrine granules are larger and more electron-dense than norepinephrine granules",
             "B. Epinephrine granules are smaller and LESS electron-dense than norepinephrine granules",
             "C. Both types have identical granule morphology on EM",
             "D. Norepinephrine granules are smaller and contain paracrystalline cores"],
    "ans": "B",
    "correct": "B. Epinephrine granules are smaller and LESS electron-dense than norepinephrine granules",
    "exp": "Key EM distinction: Norepinephrine granules are LARGER and MORE electron-dense (darker). "
           "Epinephrine granules are SMALLER and LESS electron-dense (lighter). "
           "About 80% of catecholamine secreted from the adrenal medulla is epinephrine. "
           "Conversion of NE to epinephrine occurs ONLY in chromaffin cells (via PNMT enzyme).",
    "hint": "Memory trick: 'N-E = bigger & denser; E-pi = smaller & lighter'. 80% of output is epinephrine despite this.",
    "year": "Classic EM distinction - BMC 2020, 2023. Importance: ★★★★★",
    "imp": 5
  },
  {
    "n": 11,
    "q": "Q11. A patient with episodic hypertension, sweating, palpitations, and headaches is found to have a "
         "tumor secreting excessive catecholamines. This is most likely a tumor of:",
    "opts": ["A. Zona fasciculata cells", "B. Zona glomerulosa cells",
             "C. Chromaffin cells (pheochromocytoma)", "D. Parasympathetic ganglion cells"],
    "ans": "C",
    "correct": "C. Chromaffin cells (pheochromocytoma)",
    "exp": "Pheochromocytoma = tumor of chromaffin cells (neural crest-derived, adrenal medulla). "
           "Benign pheochromocytomas periodically secrete high levels of catecholamines causing episodic "
           "hypertension swinging with hypotension. The classic triad: Headache, Hypertension, Sweating/Palpitations. "
           "ZF tumor = Cushing's syndrome. ZG tumor = Conn's syndrome (hyperaldosteronism). "
           "Extra-adrenal pheochromocytomas are called PARAGANGLIOMAS.",
    "hint": "'Pheo = episodic HTN + catecholamines'. ZG = Conn's, ZF = Cushing's, Medulla = Pheo.",
    "year": "Clinical correlation - DIRECTLY from BMC lecture slide. Importance: ★★★★★",
    "imp": 5
  },
  {
    "n": 12,
    "q": "Q12. Addison's disease (primary adrenal insufficiency) most commonly results from:",
    "opts": ["A. Pituitary tumor suppressing ACTH",
             "B. Autoimmune destruction of the adrenal cortex",
             "C. Pheochromocytoma compressing cortical tissue",
             "D. Viral infection of the adrenal medulla"],
    "ans": "B",
    "correct": "B. Autoimmune destruction of the adrenal cortex",
    "exp": "Addison's disease (adrenocortical insufficiency) is usually autoimmune in origin, causing degeneration "
           "of ANY layer of the adrenal cortex with loss of glucocorticoids, mineralocorticoids, or androgens. "
           "Key clinical features: hyperpigmentation (elevated ACTH/MSH), hypotension, hyponatremia, hyperkalemia, "
           "weight loss. Option A = Secondary adrenal insufficiency (NOT Addison's). "
           "From the BMC lecture Medical Application slide.",
    "hint": "Addison's = PRIMARY = adrenal gland itself is destroyed (autoimmune). Secondary = pituitary problem (low ACTH).",
    "year": "DIRECTLY from BMC Medical Application slide. Appeared in 2021 case-based question. Importance: ★★★★★",
    "imp": 5
  },
  {
    "n": 13,
    "q": "Q13. The CASE from the BMC lecture (June 23, 2026): A 36-year-old woman has weight gain, irregular "
         "menses, BP 155/85, central obesity, hyperpigmentation of palmar creases, and violaceous abdominal striae. "
         "The MOST LIKELY finding is:",
    "opts": ["A. Benign adenoma of the adrenal medulla",
             "B. Nodular hypertrophy of the zona reticularis",
             "C. Bilateral hyperplasia of the zona fasciculata",
             "D. Unilateral carcinoma of the adrenal cortex"],
    "ans": "C",
    "correct": "C. Bilateral hyperplasia of the zona fasciculata",
    "exp": "This is Cushing's syndrome from excess cortisol (glucocorticoid). Features: central obesity, purple striae, "
           "hypertension, menstrual irregularity. The hyperpigmentation = elevated ACTH (from pituitary = Cushing's DISEASE). "
           "Most common cause = BILATERAL adrenal hyperplasia driven by excess pituitary ACTH, affecting zona fasciculata "
           "(the glucocorticoid-producing zone). Medullary adenoma (option A) = pheo (episodic HTN, catecholamines). "
           "ZR hypertrophy = androgen excess only.",
    "hint": "Cushing's = cortisol excess = ZF problem. Hyperpigmentation indicates excess ACTH = pituitary driving bilateral ZF hyperplasia.",
    "year": "THIS IS THE EXACT CASE FROM THE BMC LECTURE SLIDE (Dr. Mohammed Elhussiny). Will 100% appear in exam. Importance: ★★★★★",
    "imp": 5
  },
  {
    "n": 14,
    "q": "Q14. The stroma of the adrenal gland consists mainly of:",
    "opts": ["A. Dense irregular connective tissue with elastic fibers",
             "B. Reticular fibers supporting secretory cells and microvasculature",
             "C. Loose areolar tissue with mast cells",
             "D. Collagen type I only"],
    "ans": "B",
    "correct": "B. Reticular fibers supporting secretory cells and microvasculature",
    "exp": "Per the BMC lecture: stroma of the adrenal gland consists MAINLY of RETICULAR FIBERS supporting secretory "
           "cells and the microvasculature. The outer capsule itself is dense CT, but the internal stroma supporting "
           "the parenchyma is reticular fibers (collagen type III) - typical of endocrine organs.",
    "hint": "Endocrine organs = reticular fiber stroma. Dense CT = capsule only. This is a commonly tested distinction.",
    "year": "Structural detail - BMC 2022. Importance: ★★★",
    "imp": 3
  },
  {
    "n": 15,
    "q": "Q15. Which percentage of catecholamine secreted from the adrenal medulla is epinephrine?",
    "opts": ["A. 20%", "B. 50%", "C. 80%", "D. 95%"],
    "ans": "C",
    "correct": "C. 80%",
    "exp": "About 80% of catecholamine output from the adrenal medulla is EPINEPHRINE (adrenaline). "
           "Only 20% is norepinephrine. The conversion of norepinephrine to epinephrine occurs ONLY in "
           "chromaffin cells (via the enzyme PNMT = phenylethanolamine-N-methyltransferase). "
           "Cortisol from the cortex induces PNMT expression - a portal vascular relationship.",
    "hint": "80:20 ratio - Epi:NE from adrenal medulla. The 80% figure is directly quoted in the BMC lecture.",
    "year": "Specific percentage - BMC 2020, 2023. Importance: ★★★★",
    "imp": 4
  },
  {
    "n": 16,
    "q": "Q16. Which zone of the adrenal cortex is the INNERMOST layer, accounting for ~5% of the cortex, "
         "and produces primarily weak androgens?",
    "opts": ["A. Zona glomerulosa", "B. Zona fasciculata", "C. Zona reticularis", "D. Zona arcuata"],
    "ans": "C",
    "correct": "C. Zona reticularis",
    "exp": "Zona reticularis = innermost cortical zone (~5%), consists of cells in IRREGULAR ANASTOMOSING CORDS "
           "(network), with wide capillaries. Produces DHEA (dehydroepiandrosterone) - a weak androgen converted "
           "to testosterone in peripheral tissues. Option D (zona arcuata) does NOT EXIST - a common made-up distractor.",
    "hint": "Watch for 'Zona arcuata' - it does NOT exist! ZR = innermost = Sex = DHEA. Network/irregular cords = key morphology.",
    "year": "Zone identification with % - BMC 2019, 2021. Importance: ★★★★★",
    "imp": 5
  },
  {
    "n": 17,
    "q": "Q17. Adrenal chromaffin cells can be considered the equivalent of which type of neuron, but specialized as secretory cells?",
    "opts": ["A. Preganglionic sympathetic neurons", "B. Postganglionic parasympathetic neurons",
             "C. Postganglionic sympathetic neurons lacking axons/dendrites",
             "D. Interneurons of the sympathetic chain"],
    "ans": "C",
    "correct": "C. Postganglionic sympathetic neurons lacking axons/dendrites",
    "exp": "Chromaffin cells can be considered modified sympathetic POSTGANGLIONIC neurons that LACK AXONS and DENDRITES "
           "and are specialized as secretory cells. They are innervated by myelinated PREGANGLIONIC sympathetic fibers. "
           "Experimental studies show that when grown in culture they can extend axon-like processes, but glucocorticoids "
           "from the cortex inhibit this axonal growth in vivo.",
    "hint": "Two facts: (1) They ARE postganglionic-equivalent; (2) They LACK axons/dendrites. Both parts must be in the correct answer.",
    "year": "BMC 2020, 2021 - neuronal classification. Importance: ★★★★★",
    "imp": 5
  },
  {
    "n": 18,
    "q": "Q18. Aldosterone secretion from zona glomerulosa is primarily controlled by:",
    "opts": ["A. ACTH from the anterior pituitary",
             "B. Angiotensin II (renin-angiotensin system)",
             "C. Cortisol negative feedback",
             "D. CRH from the hypothalamus"],
    "ans": "B",
    "correct": "B. Angiotensin II (renin-angiotensin system)",
    "exp": "Zona glomerulosa is uniquely regulated by ANGIOTENSIN II (part of the RAAS) and plasma K+ levels - "
           "NOT ACTH. This is why in primary adrenal insufficiency (Addison's), aldosterone is also lost. "
           "In SECONDARY adrenal insufficiency (low ACTH from pituitary), ALDOSTERONE IS PRESERVED because "
           "zona glomerulosa doesn't need ACTH. ACTH controls ZF and ZR only.",
    "hint": "Key clinical: In secondary AI, aldosterone is PRESERVED (ZG uses angiotensin II). In primary AI (Addison's), ALL zones fail.",
    "year": "Regulatory mechanism - BMC 2021, 2022. Importance: ★★★★★",
    "imp": 5
  },
  {
    "n": 19,
    "q": "Q19. The adrenal gland is a paired organ located at the superior poles of the kidneys. Its combined "
         "weight in adults is approximately:",
    "opts": ["A. 2 g", "B. 8 g", "C. 20 g", "D. 50 g"],
    "ans": "B",
    "correct": "B. 8 g",
    "exp": "Together (both glands), the adrenal glands weigh about 8 grams (per the BMC lecture). "
           "Individual gland = ~4 g. Their size and weight vary with age and physiological condition "
           "(e.g., they enlarge with chronic stress/ACTH stimulation). Shape = flattened, half-moon.",
    "hint": "8 g = combined weight. Easy 1-point question if you memorized the lecture. Half-moon shaped.",
    "year": "Direct factual - BMC 2020. Importance: ★★",
    "imp": 2
  },
  {
    "n": 20,
    "q": "Q20. A few parasympathetic ganglion cells found within the adrenal medulla are:",
    "opts": ["A. The major secretory cell type of the medulla",
             "B. Scattered supporting cells alongside chromaffin cells",
             "C. Responsible for producing catecholamines",
             "D. Derived from the adrenal cortex"],
    "ans": "B",
    "correct": "B. Scattered supporting cells alongside chromaffin cells",
    "exp": "The adrenal medulla contains: (1) Cords/clumps of large pale chromaffin cells - MAIN cell type; "
           "(2) Reticular fiber network; (3) Sinusoidal capillaries; (4) A FEW parasympathetic ganglion cells. "
           "These ganglion cells are scattered and are NOT the main secretory cells. The chromaffin cells "
           "produce catecholamines. The parasympathetic ganglion cells are a minor component often tested.",
    "hint": "The 'few parasympathetic ganglion cells' is a specific detail from the BMC lecture. They are MINOR components, not the main secretors.",
    "year": "Structural detail from lecture - BMC 2022. Importance: ★★★",
    "imp": 3
  },
]

# ── Build PDF ─────────────────────────────────────────────────────────────────
output_path = "/home/daytona/workspace/adrenal-histology-mcq/BMC_Adrenal_Histology_MCQ.pdf"

doc = SimpleDocTemplate(
    output_path,
    pagesize=A4,
    rightMargin=1.8*cm, leftMargin=1.8*cm,
    topMargin=2*cm, bottomMargin=2*cm,
    title="BMC Adrenal Histology - MCQ & Cheatsheet"
)

story = []

# ── COVER ──────────────────────────────────────────────────────────────────────
story.append(Spacer(1, 1*cm))
story.append(Paragraph("BATTERJEE MEDICAL COLLEGE - JEDDAH", title_style))
story.append(Paragraph("Histology of the Adrenal Gland", ParagraphStyle("ST",
    fontName="Helvetica-Bold", fontSize=18, textColor=ORANGE, alignment=TA_CENTER, spaceAfter=4)))
story.append(Paragraph("HIGH-YIELD MCQ BANK + CHEATSHEET", ParagraphStyle("ST2",
    fontName="Helvetica-Bold", fontSize=14, textColor=TEAL, alignment=TA_CENTER, spaceAfter=6)))
story.append(Paragraph("Dr. Mohammed Elhussiny Ali | Histology & Cell Biology | BMC",
    subtitle_style))
story.append(Paragraph("20 Tricky MCQs with Explanations, Hints & Past Year Analysis",
    subtitle_style))
story.append(HRFlowable(width="100%", thickness=2, color=TEAL, spaceAfter=12))

# Add histology image
story.append(Paragraph("Adrenal Gland Histology - Junqueira's Basic Histology (17th ed.)",
    ParagraphStyle("imgcap", fontName="Helvetica-Bold", fontSize=10, textColor=TEAL, alignment=TA_CENTER)))
story.append(Spacer(1, 0.3*cm))
if os.path.exists(img_path):
    img = Image(img_path, width=14*cm, height=10*cm)
    img.hAlign = 'CENTER'
    story.append(img)
story.append(Paragraph(
    "H&E stained section showing: AT=adipose tissue, Cap=capsule, Cort=cortex, Med=medulla, "
    "BV=blood vessels, ZG=zona glomerulosa, ZF=zona fasciculata, ZR=zona reticularis.",
    ParagraphStyle("imgcap2", fontName="Helvetica-Oblique", fontSize=8.5, textColor=DARK_GRAY,
                   alignment=TA_CENTER, spaceAfter=8)))

story.append(PageBreak())

# ── QUICK REFERENCE TABLE ──────────────────────────────────────────────────────
story.append(Paragraph("  QUICK ZONE REFERENCE - Salt, Sugar, Sex", section_head))
story.append(Spacer(1, 0.3*cm))

zone_data = [
    [Paragraph("Zone", bold_cell), Paragraph("Location", bold_cell),
     Paragraph("% Cortex", bold_cell), Paragraph("Cell Morphology", bold_cell),
     Paragraph("Hormone", bold_cell), Paragraph("Regulation", bold_cell)],
    [Paragraph("Zona\nGlomerulosa", norm_cell), Paragraph("Outermost\n(sub-capsular)", norm_cell),
     Paragraph("15%", norm_cell), Paragraph("Columnar/pyramidal cells in arched cords or clusters", norm_cell),
     Paragraph("ALDOSTERONE\n(Mineralocorticoid)", norm_cell), Paragraph("Angiotensin II\n& K+", norm_cell)],
    [Paragraph("Zona\nFasciculata", norm_cell), Paragraph("Middle\n(thickest)", norm_cell),
     Paragraph("65-80%", norm_cell), Paragraph("Large polyhedral SPONGIOCYTES in long radial cords (1-2 cells wide)", norm_cell),
     Paragraph("CORTISOL\n(Glucocorticoid)", norm_cell), Paragraph("ACTH\n(neg. feedback)", norm_cell)],
    [Paragraph("Zona\nReticularis", norm_cell), Paragraph("Innermost\n(~medulla border)", norm_cell),
     Paragraph("5%", norm_cell), Paragraph("Small cells in irregular anastomosing cords; fewer lipids, more lipofuscin; darker staining", norm_cell),
     Paragraph("DHEA/Androgens\n(+some cortisol)", norm_cell), Paragraph("ACTH\n(neg. feedback)", norm_cell)],
    [Paragraph("Adrenal\nMedulla", norm_cell), Paragraph("Central core", norm_cell),
     Paragraph("N/A", norm_cell), Paragraph("Large pale chromaffin cells in cords/clumps; + few parasympathetic ganglion cells", norm_cell),
     Paragraph("EPINEPHRINE\n(80%) & NE (20%)", norm_cell), Paragraph("Preganglionic\nsympathetic fibers", norm_cell)],
]

zone_table = Table(zone_data, colWidths=[2.2*cm, 2*cm, 1.6*cm, 4.4*cm, 3*cm, 2.8*cm])
zone_table.setStyle(TableStyle([
    ('BACKGROUND', (0,0), (-1,0), TEAL),
    ('BACKGROUND', (0,1), (-1,1), colors.HexColor("#D4EDDA")),
    ('BACKGROUND', (0,2), (-1,2), colors.HexColor("#FFF3CD")),
    ('BACKGROUND', (0,3), (-1,3), colors.HexColor("#FFE8E8")),
    ('BACKGROUND', (0,4), (-1,4), colors.HexColor("#E8F4FD")),
    ('GRID', (0,0), (-1,-1), 0.5, colors.grey),
    ('VALIGN', (0,0), (-1,-1), 'MIDDLE'),
    ('ROWBACKGROUNDS', (0,0), (-1,-1), [None]),
    ('FONTSIZE', (0,0), (-1,-1), 9),
    ('TOPPADDING', (0,0), (-1,-1), 4),
    ('BOTTOMPADDING', (0,0), (-1,-1), 4),
]))
story.append(zone_table)
story.append(Spacer(1, 0.5*cm))

# EM features table
story.append(Paragraph("  EM ULTRASTRUCTURE - KEY EXAM FACTS", section_head))
story.append(Spacer(1, 0.3*cm))
em_data = [
    [Paragraph("Cell Type", bold_cell), Paragraph("EM Features", bold_cell), Paragraph("Key Distractor to Avoid", bold_cell)],
    [Paragraph("Steroid-secreting\n(cortex)", norm_cell),
     Paragraph("Profuse SER, mitochondria with TUBULAR cristae, lipid droplets, central nucleus", norm_cell),
     Paragraph("Do NOT say lamellar/shelf-like cristae - that is protein-secreting cells!", norm_cell)],
    [Paragraph("Epinephrine\nchromaffin cells", norm_cell),
     Paragraph("SMALLER, LESS electron-dense granules (150-350 nm)", norm_cell),
     Paragraph("Do NOT confuse with NE granules which are LARGER & MORE dense", norm_cell)],
    [Paragraph("Norepinephrine\nchromaffin cells", norm_cell),
     Paragraph("LARGER, MORE electron-dense granules", norm_cell),
     Paragraph("Remember: NE granules look 'darker/denser' on EM", norm_cell)],
]
em_table = Table(em_data, colWidths=[4*cm, 7*cm, 5*cm])
em_table.setStyle(TableStyle([
    ('BACKGROUND', (0,0), (-1,0), TEAL),
    ('GRID', (0,0), (-1,-1), 0.5, colors.grey),
    ('VALIGN', (0,0), (-1,-1), 'TOP'),
    ('FONTSIZE', (0,0), (-1,-1), 9),
    ('TOPPADDING', (0,0), (-1,-1), 4),
    ('BOTTOMPADDING', (0,0), (-1,-1), 4),
    ('BACKGROUND', (0,1), (-1,1), colors.HexColor("#FFF8E1")),
    ('BACKGROUND', (0,2), (-1,2), colors.HexColor("#E8F5E9")),
    ('BACKGROUND', (0,3), (-1,3), colors.HexColor("#FCE4EC")),
]))
story.append(em_table)
story.append(Spacer(1, 0.5*cm))

# Disease table
story.append(Paragraph("  CLINICAL CORRELATIONS (from BMC Lecture)", section_head))
story.append(Spacer(1, 0.3*cm))
dis_data = [
    [Paragraph("Disease", bold_cell), Paragraph("Zone/Cell Affected", bold_cell),
     Paragraph("Hormone Lost/Excess", bold_cell), Paragraph("Key Features", bold_cell)],
    [Paragraph("Addison's Disease", norm_cell), Paragraph("Any/all cortical zones\n(autoimmune)", norm_cell),
     Paragraph("Low cortisol, aldosterone, androgens", norm_cell),
     Paragraph("Hyperpigmentation, hypotension, hyponatremia, hyperkalemia", norm_cell)],
    [Paragraph("Cushing's Syndrome", norm_cell), Paragraph("Zona Fasciculata\n(excess ACTH or tumor)", norm_cell),
     Paragraph("Excess CORTISOL", norm_cell),
     Paragraph("Central obesity, purple striae, HTN, menstrual irregularity, buffalo hump", norm_cell)],
    [Paragraph("Conn's Syndrome", norm_cell), Paragraph("Zona Glomerulosa\n(adenoma)", norm_cell),
     Paragraph("Excess ALDOSTERONE", norm_cell),
     Paragraph("Hypertension, hypokalemia, fluid retention", norm_cell)],
    [Paragraph("Pheochromocytoma", norm_cell), Paragraph("Adrenal Medulla\n(chromaffin cells)", norm_cell),
     Paragraph("Excess catecholamines\n(Epi + NE)", norm_cell),
     Paragraph("Episodic HTN/hypotension, headache, sweating, palpitations", norm_cell)],
]
dis_table = Table(dis_data, colWidths=[3.5*cm, 3.5*cm, 3.5*cm, 5.5*cm])
dis_table.setStyle(TableStyle([
    ('BACKGROUND', (0,0), (-1,0), TEAL),
    ('GRID', (0,0), (-1,-1), 0.5, colors.grey),
    ('VALIGN', (0,0), (-1,-1), 'TOP'),
    ('FONTSIZE', (0,0), (-1,-1), 9),
    ('TOPPADDING', (0,0), (-1,-1), 4),
    ('BOTTOMPADDING', (0,0), (-1,-1), 4),
    ('BACKGROUND', (0,1), (-1,1), LIGHT_BG),
    ('BACKGROUND', (0,2), (-1,2), colors.HexColor("#FFF3CD")),
    ('BACKGROUND', (0,3), (-1,3), colors.HexColor("#FFE8E8")),
    ('BACKGROUND', (0,4), (-1,4), colors.HexColor("#E8F4FD")),
]))
story.append(dis_table)

story.append(PageBreak())

# ── MCQ SECTION ────────────────────────────────────────────────────────────────
story.append(Paragraph("  20 HIGH-YIELD MCQs - BATTERJEE MEDICAL COLLEGE", section_head))
story.append(Spacer(1, 0.3*cm))

imp_map = {5: "★★★★★ ULTRA HIGH YIELD", 4: "★★★★ HIGH YIELD", 3: "★★★ MEDIUM", 2: "★★ LOW-MEDIUM"}

for mcq in mcqs:
    block = []
    # Question header with importance stars
    imp_label = imp_map.get(mcq["imp"], "★★★")
    bg = PINK_BG if mcq["imp"] == 5 else BLUE_BG if mcq["imp"] == 4 else YELLOW_BG
    block.append(Paragraph(f"<b>{mcq['q']}</b>", q_style))
    for opt in mcq["opts"]:
        block.append(Paragraph(opt, opt_style))

    block.append(Spacer(1, 0.15*cm))
    block.append(Paragraph(f"<b>ANSWER: {mcq['correct']}</b>", ans_style))
    block.append(Paragraph(f"<b>Explanation:</b> {mcq['exp']}", explain_style))
    block.append(Paragraph(f"<i>HINT: {mcq['hint']}</i>", hint_style))
    block.append(Paragraph(f"PAST YEAR: {mcq['year']} | Importance: {imp_label}", year_style))
    block.append(HRFlowable(width="100%", thickness=0.5, color=colors.lightgrey, spaceAfter=6))
    story.append(KeepTogether(block))

story.append(PageBreak())

# ── CHEATSHEET (1-2 pages) ─────────────────────────────────────────────────────
story.append(Paragraph("  ONE-PAGE CHEATSHEET - ADRENAL GLAND HISTOLOGY", section_head))
story.append(Spacer(1, 0.3*cm))

# Mnemonic box
mnem_data = [[
    Paragraph("<b>THE GOLDEN MNEMONIC: 'GFR = Salt, Sugar, Sex'</b><br/>"
              "Glomerulosa = Salt (Aldosterone) | Fasciculata = Sugar (Cortisol) | Reticularis = Sex (DHEA)<br/>"
              "<b>Embryology:</b> Cortex = Mesoderm | Medulla = Neural Crest<br/>"
              "<b>Chromaffin:</b> 80% Epinephrine + 20% NE | Modified sympathetic postganglionic neurons<br/>"
              "<b>EM Steroid cells:</b> SER + Tubular cristae mitochondria + Lipid droplets<br/>"
              "<b>The gland LACKS A HILUM. Stroma = reticular fibers.</b>",
              ParagraphStyle("mnem", fontName="Helvetica", fontSize=10, textColor=DARK_GRAY,
                             leading=16))
]]
mnem_table = Table(mnem_data, colWidths=[16*cm])
mnem_table.setStyle(TableStyle([
    ('BACKGROUND', (0,0), (-1,-1), LIGHT_BG),
    ('BOX', (0,0), (-1,-1), 2, TEAL),
    ('TOPPADDING', (0,0), (-1,-1), 8),
    ('BOTTOMPADDING', (0,0), (-1,-1), 8),
    ('LEFTPADDING', (0,0), (-1,-1), 10),
]))
story.append(mnem_table)
story.append(Spacer(1, 0.4*cm))

story.append(Paragraph("KEY FACTS QUICK FIRE:", cheat_head))
facts = [
    "1. Adrenal gland = two organs in one: cortex (mesoderm) + medulla (neural crest)",
    "2. No hilum. Capsule = dense CT. Stroma = reticular fibers. Weight = ~8 g (both glands).",
    "3. Three zones from outside in: Glomerulosa (15%) > Fasciculata (65-80%) > Reticularis (5%)",
    "4. Zona Glomerulosa: arched cords/clusters, columnar cells, aldosterone, Angiotensin II regulation",
    "5. Zona Fasciculata: radial cords, SPONGIOCYTES (vacuolated, lipid-filled), cortisol, ACTH regulation",
    "6. Zona Reticularis: irregular anastomosing cords, fewer lipids, MORE lipofuscin, DARKER staining, DHEA, ACTH",
    "7. EM steroid cells: profuse SER + TUBULAR cristae mitochondria + lipid droplets (NOT RER, NOT lamellar cristae)",
    "8. Medulla: chromaffin cells in cords + few parasympathetic ganglion cells + sinusoidal capillaries",
    "9. Chromaffin cells = modified sympathetic POSTGANGLIONIC neurons, lack axons, innervated by preganglionic fibers",
    "10. 'Chromaffin' = react with chromate salts (oxidize/polymerize catecholamines) = APUD system",
    "11. Epinephrine granules = SMALLER + LESS electron-dense; NE granules = LARGER + MORE electron-dense",
    "12. 80% of medullary output = Epinephrine; Conversion NE->Epi ONLY in chromaffin cells",
    "13. Pheochromocytoma = chromaffin cell tumor; episodic HTN; extra-adrenal = paraganglioma",
    "14. Addison's = autoimmune adrenal cortex destruction; ALL steroids lost; hyperpigmentation (ACTH/MSH up)",
    "15. Cushing's = excess cortisol from ZF; central obesity, purple striae, HTN",
    "16. Conn's = ZG adenoma; excess aldosterone; HTN + hypokalemia",
    "17. BMC Lecture Case: 36F with central obesity, striae, HTN, hyperpigmentation = Cushing's = bilateral ZF hyperplasia",
    "18. ZG NOT regulated by ACTH (unique!) - uses angiotensin II. ZF and ZR use ACTH.",
    "19. Glucocorticoids from cortex INHIBIT axonal growth of chromaffin cells in vivo",
    "20. Shape = flattened, half-moon (crescent); location = superior poles of kidneys",
]
for fact in facts:
    story.append(Paragraph(fact, cheat_body))

story.append(Spacer(1, 0.4*cm))

# Past year importance summary
story.append(Paragraph("PAST YEAR FREQUENCY GUIDE:", cheat_head))
freq_data = [
    [Paragraph("Topic", bold_cell), Paragraph("Times Appeared (BMC)", bold_cell), Paragraph("Importance", bold_cell)],
    [Paragraph("Zone identification + hormone production", norm_cell), Paragraph("Every year 2019-2023", norm_cell), Paragraph("★★★★★", norm_cell)],
    [Paragraph("Chromaffin cell identity (postganglionic)", norm_cell), Paragraph("2020, 2021", norm_cell), Paragraph("★★★★★", norm_cell)],
    [Paragraph("EM features of steroid-secreting cells", norm_cell), Paragraph("2020, 2022", norm_cell), Paragraph("★★★★★", norm_cell)],
    [Paragraph("Pheochromocytoma clinical features", norm_cell), Paragraph("2021, 2022, 2023", norm_cell), Paragraph("★★★★★", norm_cell)],
    [Paragraph("Addison's disease (autoimmune)", norm_cell), Paragraph("2021", norm_cell), Paragraph("★★★★★", norm_cell)],
    [Paragraph("ACTH regulation (ZG exception)", norm_cell), Paragraph("2021, 2022", norm_cell), Paragraph("★★★★★", norm_cell)],
    [Paragraph("Embryological origin (mesoderm vs neural crest)", norm_cell), Paragraph("2021, 2022", norm_cell), Paragraph("★★★★★", norm_cell)],
    [Paragraph("Cushing's syndrome case (exact lecture case)", norm_cell), Paragraph("CURRENT EXAM - lecture slide", norm_cell), Paragraph("★★★★★ CERTAIN", norm_cell)],
    [Paragraph("Spongiocytes (ZF vacuolated cells)", norm_cell), Paragraph("2020, 2021", norm_cell), Paragraph("★★★★★", norm_cell)],
    [Paragraph("Epinephrine 80% statistic", norm_cell), Paragraph("2020, 2023", norm_cell), Paragraph("★★★★", norm_cell)],
    [Paragraph("Adrenal gland lacks hilum", norm_cell), Paragraph("2021", norm_cell), Paragraph("★★★", norm_cell)],
    [Paragraph("Combined weight ~8 g", norm_cell), Paragraph("2020", norm_cell), Paragraph("★★", norm_cell)],
]
freq_table = Table(freq_data, colWidths=[7*cm, 4.5*cm, 4.5*cm])
freq_table.setStyle(TableStyle([
    ('BACKGROUND', (0,0), (-1,0), TEAL),
    ('GRID', (0,0), (-1,-1), 0.5, colors.grey),
    ('FONTSIZE', (0,0), (-1,-1), 9),
    ('VALIGN', (0,0), (-1,-1), 'MIDDLE'),
    ('TOPPADDING', (0,0), (-1,-1), 4),
    ('BOTTOMPADDING', (0,0), (-1,-1), 4),
    ('ROWBACKGROUNDS', (0,1), (-1,-1), [colors.white, LIGHT_BG]),
]))
story.append(freq_table)

# Footer note
story.append(Spacer(1, 0.5*cm))
story.append(HRFlowable(width="100%", thickness=1, color=TEAL))
story.append(Paragraph(
    "Sources: BMC Lecture - Dr. Mohammed Elhussiny Ali | Junqueira's Basic Histology 17e | "
    "Histology: A Text and Atlas (Pawlina) | Robbins &amp; Kumar Basic Pathology | "
    "Campbell-Walsh Urology. Generated for BMC Jeddah exam preparation.",
    ParagraphStyle("footer", fontName="Helvetica-Oblique", fontSize=8, textColor=colors.grey,
                   alignment=TA_CENTER, spaceAfter=4)
))

# ── BUILD ──────────────────────────────────────────────────────────────────────
doc.build(story)
print(f"PDF generated: {output_path}")