pnimit-mega-dev

name

pnimit-mega-dev

description

Complete development skill for Pnimit Mega (שלב א מגה — פנימית), an Israeli internal medicine board exam PWA. ALWAYS use this skill when: modifying Pnimit Mega code, fixing bugs, adding features, parsing new exam PDFs, adding questions/flashcards/notes, pushing to GitHub, or anything related to the InternalMedicine repo. Also trigger on: "pnimit", "internal medicine board", "פנימית מגה", "P0064-2025", references to eiasash.github.io/InternalMedicine, "parse exam", "add questions", "pnimit bug", or any mention of the InternalMedicine repo. Contains repo structure, data formats, deployment pipeline, exam parsing patterns, and content creation conventions. Always read this before touching any Pnimit code.

Pnimit Mega — Development Skill

Identity

• App: Pnimit Mega (שלב א מגה — רפואה פנימית)
• URL: https://eiasash.github.io/InternalMedicine/
• Repo: github.com/Eiasash/InternalMedicine
• Version: v9.36
• Stack: Single-file HTML PWA, vanilla JS, GitHub Pages
• Syllabus: P0064-2025 (Israeli Internal Medicine Stage A)
• Sibling app: Shlav A Mega (geriatrics) at Eiasash/Geriatrics — same engine, different syllabus & data

Critical: This Is NOT the Geriatrics App

Aspect	Pnimit Mega (THIS)	Shlav A Mega (sibling)
Specialty	Internal Medicine (פנימית)	Geriatrics (גריאטריה)
Syllabus	P0064-2025	P005-2026
Textbooks	Harrison's 22e ONLY	Hazzard's 8e + Harrison's 22e
Laws/regulations	None	15 Israeli laws
Topics	24 (IM subspecialties)	40 (geriatric syndromes)
localStorage key	pnimit_mega	samega
IndexedDB	pnimit_mega_db	shlav_mega_db
SW cache	pnimit-v9.30	shlav-a-v9.30
Questions	913	1,470
Articles	10 (NEJM/Lancet)	6 (geriatric)

P0064-2025 Syllabus — Internal Medicine Stage A

Exam Structure

The exam is MCQ-based, held twice yearly (May/June and October). ~100 questions per session. All questions are in Hebrew with 4 options (א–ד). Some include clinical images.

Core Textbook

Harrison's Principles of Internal Medicine, 22nd Edition — selected chapters per syllabus. NO Hazzard's, NO GRS, NO Israeli laws (those are geriatrics-only).

Harrison's 22e Required Chapters (P0064-2025)

Symptoms & Signs: 14 (Pain), 15 (Chest), 16 (Abdominal Pain), 17 (Headache), 18 (Low Back), 20 (Fever), 22 (FUO), 30 (Coma), 39 (Dyspnea), 40 (Cough), 41 (Hemoptysis), 42 (Hypoxia), 43 (Edema) GI: 48 (N/V), 49 (Diarrhea/Constipation), 50 (Weight Loss), 51 (GI Bleeding), 52 (Jaundice), 53 (Ascites), 332 (GI Disease), 347 (Liver Function), 355 (Cirrhosis) Renal: 55 (Azotemia), 56 (Fluids/Lytes), 57 (Calcium), 58 (Acid-Base), 319 (Renal Disease), 321 (AKI), 322 (CKD) Heme/Onc: 66 (Anemia), 67 (Granulocytes), 69 (Bleeding/Thrombosis), 70 (Lymph/Spleen), 79 (Infections in Cancer), 80 (Onc Emergencies), 102 (Iron Deficiency), 120 (Platelet Disorders), 121 (Coag Disorders) ID: 127 (Acutely Ill Febrile), 133 (Endocarditis), 136 (Osteomyelitis), 142 (Encephalitis), 143 (Meningitis), 147 (HAIs) Cards: 243 (CV Disease), 247 (ECG), 285 (NSTEMI/UA), 286 (STEMI) Pulm: 295 (Respiratory Disease), 305 (Pleura) Critical Care: 311 (Critical Illness), 314 (Shock), 315 (Sepsis), 316 (Cardiogenic Shock), 317 (Cardiac Arrest) Rheum: 375 (Vasculitis), 379 (Sarcoidosis), 382 (Articular/MSK), 384 (Gout/Crystal), 387 (Periarticular) Neuro: 26 (Neurologic Weakness), 433 (Neurologic Disease), 436 (Seizures), 437 (Cerebrovascular), 438 (Ischemic Stroke), 439 (ICH), 458 (GBS), 459 (Myasthenia) Endo: 388 (Endocrine Disorders)

Required Articles (10)

#	Article	Trial/Topic	File
1	Digitoxin in HFrEF	DIGIT-HF	01_digitoxin_hfref.pdf
2	cfDNA Blood Test for CRC Screening	ECLIPSE	02_cfdna_crc_screening.pdf
3	BSI 7 vs 14 Days	BALANCE	03_bsi_7vs14_days.pdf
4	Aspirin + OAC in Chronic Coronary Syndrome	—	04_aspirin_ccs_oac.pdf
5	Baxdrostat for Resistant HTN	—	05_baxdrostat_htn.pdf
6	Apixaban Extended VTE Treatment	—	06_apixaban_vte.pdf
7	Upadacitinib for GCA	SELECT-GCA	07_upadacitinib_gca.pdf
8	Sarcoidosis Prednisone vs MTX	FIRE	08_sarcoidosis_pred_mtx.pdf
9	Sotatercept for PAH	STELLAR	09_sotatercept_pah.pdf
10	ECST-2 Carotid Stenosis	ECST-2	10_ecst2_carotid.pdf

Repo Structure

InternalMedicine/
├── index.html                  # Redirect → pnimit-mega.html
├── pnimit-mega.html            # THE APP (~253KB, single file, all JS/CSS inline)
├── manifest.json               # PWA manifest
├── sw.js                       # Service worker (cache: pnimit-v9.30)
├── CLAUDE.md                   # Dev instructions for Claude
├── README.md
├── data/
│   ├── questions.json          # 913 MCQs with explanations
│   ├── drugs.json              # 53 drugs (ACB scores, Beers flags, STOPP interactions)
│   ├── flashcards.json         # 100 flashcards
│   ├── notes.json              # 24 study notes
│   ├── topics.json             # 24 topic keyword arrays
│   └── tabs.json               # 10 tab definitions
├── articles/                   # 10 required article PDFs
├── exams/                      # 7 raw past exams (2020–2025)
├── harrison/                   # 69 Harrison's 22e chapter PDFs
├── harrison_chapters.json      # Harrison's 22e in-app reader (~3.8MB)
├── questions/
│   ├── image_map.json
│   └── images/                 # 128 exam images
├── syllabus/
│   └── P0064-2025.pdf
├── skill/
│   └── SKILL.md                # This file
└── tests/                      # Vitest test suite (TBD)

Data Formats

questions.json

{
  "q": "שאלה בעברית...",
  "o": ["א. אפשרות", "ב. אפשרות", "ג. אפשרות", "ד. אפשרות"],
  "c": 2,           // 0-based correct index
  "t": "Jun23",     // exam session tag
  "e": "הסבר...",    // AI explanation
  "img": "questions/images/img_Jun23_5.jpg",  // optional
  "ti": 12          // topic index (0-23)
}

Exam tags: 2020, Jun21, Jun22, Jun23, May24, Oct24, Jun25

drugs.json

{"name": "Oxybutynin", "heb": "דיטרופן", "acb": 3, "beers": true, "cat": "Anticholinergic/Bladder", "risk": "..."}

Topic Index (ti: 0–23)

0=Cardiology/CAD 1=Heart Failure 2=Arrhythmias 3=Valvular 4=Hypertension 5=Pulmonology/VTE 6=GI/Hepatology 7=Nephrology 8=Electrolytes/Acid-Base 9=Endocrinology 10=Hematology 11=Oncology 12=Infectious Disease 13=Rheumatology 14=Neurology 15=Critical Care 16=Dermatology 17=Allergy/Immunology 18=Fluids/Volume 19=Pain/Palliative 20=Perioperative 21=Toxicology 22=Clinical Approach 23=Vascular

AI Integration

Proxy (shared with Geriatrics sibling)

• Endpoint: https://toranot.netlify.app/api/claude
• Header: x-api-secret: shlav-a-mega-1f97f311d307-2026
• Model: sonnet (maps to claude-sonnet-4-6)
• Flow: Proxy first → fallback to user's personal API key
• Friends can use the app WITHOUT their own API key (proxy covers it)

AI features in-app

• Question explanations (on-demand, per question)
• Chat assistant (general medical study questions)
• Exam analysis and weak-topic identification

Development

Version bumping — update TWO places:

1. pnimit-mega.html: const APP_VERSION='X.Y';
2. sw.js: const CACHE='pnimit-vX.Y';

Deployment

git add -A && git commit -m "message" && git push origin main

GitHub Pages auto-deploys in ~60s. No build step.

Exam Parsing Pipeline

1. Parse answer key PDF → Hebrew letter mapping (א=0, ב=1, ג=2, ד=3)
2. Parse question PDF → segment by standalone number lines
3. Extract images from image PDF → PyMuPDF 200 DPI JPEG
4. Generate explanations via proxy
5. Append to data/questions.json, update questions/image_map.json

Content Stats

Content	Count
MCQ questions	1011 (all with explanations)
Questions with images	73
Exam images	128
Drugs	53
Flashcards	155
Study notes	24
Article PDFs	10
Harrison chapter PDFs	69
Past exams (raw)	7 sessions (2020–2025)
Topics	24