formanitor 0.0.40 → 0.0.42

package/dist/index.mjs

@@ -225,8 +225,21 @@ var defaultGeneralSurgerySmartHistory = () => ({
   gi: { appetite: "", weightLoss: "", bowelHabits: "", checks: [] },
   breast: { lumpDuration: "", nippleDischarge: "", checks: [] },
   ano: { checks: [] },
-  thyroid: { swellingDuration: "", checks: [] },
-  systemic: ""
+  thyroid: { swellingDuration: "", checks: [] }
+});
+var defaultBreastExamSide = () => ({
+  size: "",
+  quadrant: "",
+  tenderness: "",
+  fixity: "",
+  skinInvolvement: "",
+  consistency: "",
+  axillaryNodes: false,
+  nippleAreolarComplex: false
+});
+var defaultBreastExaminationBlock = () => ({
+  left: defaultBreastExamSide(),
+  right: defaultBreastExamSide()
 });
 var defaultGeneralSurgeryExamination = () => ({
   general: [],
@@ -239,7 +252,7 @@ var defaultGeneralSurgeryExamination = () => ({
     bowelSounds: "none"
   },
   hernia: { site: "", reducible: false, coughImpulse: false, tenderness: false },
-  breast: { lumpSizeCm: "", mobile: false, skinInvolvement: false, axillaryNodes: false },
+  breast: defaultBreastExaminationBlock(),
   thyroid: { size: "", mobileDeglutition: false, nodules: false, cervicalNodes: false },
   anorectal: { inspection: "", dreDone: false, proctoscopyDone: false, notes: "" },
   limb: { dilatedVeins: false, ulcer: false, oedema: false }
@@ -335,8 +348,32 @@ function normalizeGeneralSurgerySmartHistory(raw) {
     thyroid: {
       swellingDuration: str2(thy.swellingDuration),
       checks: strArr(thy.checks)
-    },
-    systemic: typeof v.systemic === "string" ? v.systemic : d.systemic
+    }
+  };
+}
+function normalizeBreastExamSide(partial) {
+  const e = defaultBreastExamSide();
+  const str2 = (x) => typeof x === "string" ? x : "";
+  const bool = (x) => x === true;
+  if (!partial || typeof partial !== "object") return e;
+  const p = partial;
+  return {
+    size: str2(p.size),
+    quadrant: str2(p.quadrant),
+    tenderness: str2(p.tenderness),
+    fixity: str2(p.fixity),
+    skinInvolvement: str2(p.skinInvolvement),
+    consistency: str2(p.consistency),
+    axillaryNodes: bool(p.axillaryNodes),
+    nippleAreolarComplex: bool(p.nippleAreolarComplex)
+  };
+}
+function normalizeBreastExaminationBlock(raw) {
+  if (!raw || typeof raw !== "object" || Array.isArray(raw)) return defaultBreastExaminationBlock();
+  const br = raw;
+  return {
+    left: normalizeBreastExamSide(br.left),
+    right: normalizeBreastExamSide(br.right)
   };
 }
 function normalizeGeneralSurgeryExamination(raw) {
@@ -369,12 +406,7 @@ function normalizeGeneralSurgeryExamination(raw) {
       coughImpulse: bool(hb.coughImpulse),
       tenderness: bool(hb.tenderness)
     },
-    breast: {
-      lumpSizeCm: typeof br.lumpSizeCm === "string" ? br.lumpSizeCm : "",
-      mobile: bool(br.mobile),
-      skinInvolvement: bool(br.skinInvolvement),
-      axillaryNodes: bool(br.axillaryNodes)
-    },
+    breast: normalizeBreastExaminationBlock(br),
     thyroid: {
       size: typeof th.size === "string" ? th.size : "",
       mobileDeglutition: bool(th.mobileDeglutition),
@@ -412,6 +444,259 @@ function gsGradingRowVisible(cond, chips, regions, grade) {
   if (t.regions.some((r) => regions.includes(r))) return true;
   return false;
 }
+var SWELLING_OPT_LABELS = {
+  reducible_hernia: "Reducible (hernia)",
+  cough_impulse: "Cough impulse",
+  skin_changes: "Skin changes"
+};
+var GI_OPT_LABELS = {
+  bleeding_pr: "Bleeding PR",
+  vomiting: "Vomiting",
+  haematemesis: "Haematemesis"
+};
+var BREAST_OPT_LABELS = {
+  pain: "Pain",
+  fh_ca_breast: "Family history of Ca breast"
+};
+var ANO_OPT_LABELS = {
+  pain_defecation: "Pain during defecation",
+  bleeding: "Bleeding",
+  constipation: "Constipation",
+  discharge: "Discharge"
+};
+var THYROID_OPT_LABELS = {
+  dysphagia: "Dysphagia",
+  voice_change: "Voice change",
+  thyrotoxicosis: "Thyrotoxicosis symptoms"
+};
+var SOCRATES_LABELS = {
+  site: "Site",
+  onset: "Onset",
+  character: "Character",
+  radiation: "Radiation",
+  associated: "Associated",
+  timing: "Timing",
+  exacerbating: "Exacerbating / relieving"
+};
+var GENERAL_EXAM_LABELS = {
+  pallor: "Pallor",
+  icterus: "Icterus",
+  cyanosis: "Cyanosis",
+  clubbing: "Clubbing",
+  lymphadenopathy: "Lymphadenopathy",
+  oedema: "Oedema"
+};
+var REGION_EXAM_LABELS = {
+  abdomen: "Abdomen",
+  hernia: "Hernia",
+  breast: "Breast",
+  thyroid: "Thyroid",
+  anorectal: "Anorectal",
+  limb: "Limb / varicose"
+};
+var ABD_INSP_LABELS = {
+  distension: "Distension",
+  scars: "Scars",
+  visible_peristalsis: "Visible peristalsis"
+};
+var ABD_PALP_LABELS = {
+  tenderness: "Tenderness",
+  guarding: "Guarding",
+  rigidity: "Rigidity",
+  mass: "Palpable mass"
+};
+var ABD_PERC_LABELS = {
+  tympany: "Tympany",
+  shifting_dullness: "Shifting dullness"
+};
+function trimLine(s) {
+  return s.replace(/\s+/g, " ").trim();
+}
+var SK_ORDER = ["site", "onset", "character", "radiation", "associated", "timing", "exacerbating"];
+function formatGeneralSurgerySmartHistoryToNarrative(v, chips) {
+  const blocks = [];
+  const showPain = chips.includes("pain");
+  const showSwelling = chips.includes("swelling_lump");
+  const showGI = chips.includes("bleeding") || chips.includes("obstruction");
+  const showBreast = chips.includes("breast");
+  const showAno = chips.includes("anorectal");
+  const showThyroid = chips.includes("thyroid");
+  if (showPain) {
+    const painLines = [];
+    for (const key of SK_ORDER) {
+      const raw = v.pain[key];
+      if (typeof raw === "string" && raw.trim()) {
+        painLines.push(`${SOCRATES_LABELS[key]}: ${trimLine(raw)}`);
+      }
+    }
+    if (v.pain.severity > 0) {
+      painLines.push(`Severity (0\u201310): ${v.pain.severity}`);
+    }
+    if (painLines.length > 0) {
+      blocks.push(["SOCRATES \u2014 pain", ...painLines.map((l) => `\u2022 ${l}`)].join("\n"));
+    }
+  }
+  if (showSwelling) {
+    const parts = [];
+    if (v.swelling.duration.trim()) parts.push(`Duration: ${trimLine(v.swelling.duration)}`);
+    if (v.swelling.sizeProgression.trim())
+      parts.push(`Size progression: ${trimLine(v.swelling.sizeProgression)}`);
+    if (v.swelling.painfulPainless.trim())
+      parts.push(`Painful / painless: ${trimLine(v.swelling.painfulPainless)}`);
+    for (const c of v.swelling.checks) {
+      const lb = SWELLING_OPT_LABELS[c] ?? c;
+      parts.push(lb);
+    }
+    if (parts.length > 0) {
+      blocks.push(["Swelling history", ...parts.map((p) => `\u2022 ${p}`)].join("\n"));
+    }
+  }
+  if (showGI) {
+    const parts = [];
+    if (v.gi.appetite.trim()) parts.push(`Appetite: ${trimLine(v.gi.appetite)}`);
+    if (v.gi.weightLoss.trim()) parts.push(`Weight loss: ${trimLine(v.gi.weightLoss)}`);
+    if (v.gi.bowelHabits.trim()) parts.push(`Bowel habits: ${trimLine(v.gi.bowelHabits)}`);
+    for (const c of v.gi.checks) {
+      parts.push(GI_OPT_LABELS[c] ?? c);
+    }
+    if (parts.length > 0) {
+      blocks.push(["GI history", ...parts.map((p) => `\u2022 ${p}`)].join("\n"));
+    }
+  }
+  if (showBreast) {
+    const parts = [];
+    if (v.breast.lumpDuration.trim()) parts.push(`Lump duration: ${trimLine(v.breast.lumpDuration)}`);
+    if (v.breast.nippleDischarge.trim())
+      parts.push(`Nipple discharge: ${trimLine(v.breast.nippleDischarge)}`);
+    for (const c of v.breast.checks) {
+      parts.push(BREAST_OPT_LABELS[c] ?? c);
+    }
+    if (parts.length > 0) {
+      blocks.push(["Breast history", ...parts.map((p) => `\u2022 ${p}`)].join("\n"));
+    }
+  }
+  if (showAno) {
+    const parts = [];
+    for (const c of v.ano.checks) {
+      parts.push(ANO_OPT_LABELS[c] ?? c);
+    }
+    if (parts.length > 0) {
+      blocks.push(["Anorectal history", ...parts.map((p) => `\u2022 ${p}`)].join("\n"));
+    }
+  }
+  if (showThyroid) {
+    const parts = [];
+    if (v.thyroid.swellingDuration.trim())
+      parts.push(`Swelling duration: ${trimLine(v.thyroid.swellingDuration)}`);
+    for (const c of v.thyroid.checks) {
+      parts.push(THYROID_OPT_LABELS[c] ?? c);
+    }
+    if (parts.length > 0) {
+      blocks.push(["Thyroid history", ...parts.map((p) => `\u2022 ${p}`)].join("\n"));
+    }
+  }
+  return blocks.join("\n\n");
+}
+var BOWEL_SOUND_LABELS = {
+  none: "\u2014",
+  normal: "Normal",
+  up: "Increased (\u2191)",
+  down: "Decreased (\u2193)",
+  absent: "Absent"
+};
+function formatGeneralSurgeryExaminationToNarrative(v) {
+  const blocks = [];
+  const generalPositive = v.general.map((k) => GENERAL_EXAM_LABELS[k] ?? k).filter(Boolean);
+  if (generalPositive.length > 0) {
+    blocks.push(
+      ["General examination", ...generalPositive.map((g) => `\u2022 ${g}`)].join("\n")
+    );
+  }
+  if (v.regions.length > 0) {
+    const names = v.regions.map((r) => REGION_EXAM_LABELS[r] ?? r);
+    blocks.push(`Regional examination: ${names.join(", ")}`);
+  }
+  if (v.regions.includes("abdomen")) {
+    const sub = [];
+    const ins = v.abdomen.inspection.map((x) => ABD_INSP_LABELS[x] ?? x);
+    const pal = v.abdomen.palpation.map((x) => ABD_PALP_LABELS[x] ?? x);
+    const per = v.abdomen.percussion.map((x) => ABD_PERC_LABELS[x] ?? x);
+    if (ins.length) sub.push(`Inspection: ${ins.join(", ")}`);
+    if (pal.length) sub.push(`Palpation: ${pal.join(", ")}`);
+    if (v.abdomen.massNotes.trim()) sub.push(`Mass / mobility: ${trimLine(v.abdomen.massNotes)}`);
+    if (per.length) sub.push(`Percussion: ${per.join(", ")}`);
+    const bs = BOWEL_SOUND_LABELS[v.abdomen.bowelSounds];
+    if (v.abdomen.bowelSounds !== "none") {
+      sub.push(`Bowel sounds: ${bs}`);
+    }
+    if (sub.length > 0) {
+      blocks.push(["Abdomen", ...sub.map((s) => `\u2022 ${s}`)].join("\n"));
+    }
+  }
+  if (v.regions.includes("hernia")) {
+    const sub = [];
+    if (v.hernia.site.trim()) sub.push(`Site: ${trimLine(v.hernia.site)}`);
+    if (v.hernia.reducible) sub.push("Reducible");
+    if (v.hernia.coughImpulse) sub.push("Cough impulse positive");
+    if (v.hernia.tenderness) sub.push("Tenderness");
+    if (sub.length > 0) {
+      blocks.push(["Hernia", ...sub.map((s) => `\u2022 ${s}`)].join("\n"));
+    }
+  }
+  if (v.regions.includes("breast")) {
+    const sub = [];
+    const appendSide = (label, s) => {
+      const lines = [];
+      if (s.size.trim()) lines.push(`Size: ${trimLine(s.size)}`);
+      if (s.quadrant.trim()) lines.push(`Quadrant: ${trimLine(s.quadrant)}`);
+      if (s.tenderness.trim()) lines.push(`Tenderness: ${trimLine(s.tenderness)}`);
+      if (s.fixity.trim()) lines.push(`Fixity: ${trimLine(s.fixity)}`);
+      if (s.skinInvolvement.trim()) lines.push(`Skin involvement: ${trimLine(s.skinInvolvement)}`);
+      if (s.consistency.trim()) lines.push(`Consistency: ${trimLine(s.consistency)}`);
+      if (s.axillaryNodes) lines.push("Axillary nodes");
+      if (s.nippleAreolarComplex) lines.push("Nipple-areolar complex");
+      if (lines.length > 0) {
+        sub.push(`${label}: ${lines.join("; ")}`);
+      }
+    };
+    appendSide("Left breast", v.breast.left);
+    appendSide("Right breast", v.breast.right);
+    if (sub.length > 0) {
+      blocks.push(["Breast", ...sub.map((s) => `\u2022 ${s}`)].join("\n"));
+    }
+  }
+  if (v.regions.includes("thyroid")) {
+    const sub = [];
+    if (v.thyroid.size.trim()) sub.push(`Size: ${trimLine(v.thyroid.size)}`);
+    if (v.thyroid.mobileDeglutition) sub.push("Mobile with deglutition");
+    if (v.thyroid.nodules) sub.push("Nodules");
+    if (v.thyroid.cervicalNodes) sub.push("Cervical lymph nodes");
+    if (sub.length > 0) {
+      blocks.push(["Thyroid", ...sub.map((s) => `\u2022 ${s}`)].join("\n"));
+    }
+  }
+  if (v.regions.includes("anorectal")) {
+    const sub = [];
+    if (v.anorectal.inspection.trim())
+      sub.push(`Inspection: ${trimLine(v.anorectal.inspection)}`);
+    if (v.anorectal.dreDone) sub.push("DRE done");
+    if (v.anorectal.proctoscopyDone) sub.push("Proctoscopy done");
+    if (v.anorectal.notes.trim()) sub.push(`DRE / proctoscopy notes: ${trimLine(v.anorectal.notes)}`);
+    if (sub.length > 0) {
+      blocks.push(["Anorectal", ...sub.map((s) => `\u2022 ${s}`)].join("\n"));
+    }
+  }
+  if (v.regions.includes("limb")) {
+    const sub = [];
+    if (v.limb.dilatedVeins) sub.push("Dilated veins");
+    if (v.limb.ulcer) sub.push("Ulcer");
+    if (v.limb.oedema) sub.push("Oedema");
+    if (sub.length > 0) {
+      blocks.push(["Limb / varicose", ...sub.map((s) => `\u2022 ${s}`)].join("\n"));
+    }
+  }
+  return blocks.join("\n\n");
+}
 
 // src/core/painScaleFlags.ts
 function normalizePainScaleFlags(raw, bounds) {
@@ -9236,6 +9521,7 @@ var SliderWidget = ({ fieldId }) => {
   ] });
 };
 var CHIEF_CHIPS_FIELD = "chief_complaints_chips";
+var GS_SYMPTOMS_FIELD = "symptoms";
 var SWELLING_OPTS = [
   { value: "reducible_hernia", label: "Reducible (hernia)" },
   { value: "cough_impulse", label: "Cough impulse" },
@@ -9276,16 +9562,26 @@ function Panel({ title, children }) {
     /* @__PURE__ */ jsx("div", { className: "p-3", children })
   ] });
 }
-function chipList(state) {
-  const raw = state.values[CHIEF_CHIPS_FIELD];
+function chipListFromRaw(raw) {
   return Array.isArray(raw) ? raw.filter((x) => typeof x === "string") : [];
 }
 var GsSmartHistoryWidget = ({ fieldId }) => {
   const { fieldDef, value, setValue, setTouched, error, touched, disabled } = useField(fieldId);
+  const hopcField = useField(GS_SYMPTOMS_FIELD);
   const { state } = useForm();
   const showError = !!error && (touched || state.submitAttempted);
   const safe = useMemo(() => normalizeGeneralSurgerySmartHistory(value), [value]);
-  const chips = useMemo(() => chipList(state), [state]);
+  const chiefChipsRaw = state.values[CHIEF_CHIPS_FIELD];
+  const chips = useMemo(() => chipListFromRaw(chiefChipsRaw), [chiefChipsRaw]);
+  const [hopcNarrativeLocked, setHopcNarrativeLocked] = useState(false);
+  useEffect(() => {
+    if (hopcNarrativeLocked) return;
+    const next = formatGeneralSurgerySmartHistoryToNarrative(
+      normalizeGeneralSurgerySmartHistory(value),
+      chips
+    );
+    hopcField.setValue(next);
+  }, [value, chips, hopcNarrativeLocked]);
   const showPain = chips.includes("pain");
   const showSwelling = chips.includes("swelling_lump");
   const showGI = chips.includes("bleeding") || chips.includes("obstruction");
@@ -9551,15 +9847,51 @@ var GsSmartHistoryWidget = ({ fieldId }) => {
         ] }, o.value)) })
       ] }) : null,
       /* @__PURE__ */ jsxs("div", { className: "space-y-1", children: [
-        /* @__PURE__ */ jsx(Label, { className: "text-xs font-medium text-slate-700", children: "Systemic surgical screening" }),
+        /* @__PURE__ */ jsxs("div", { className: "flex flex-wrap items-center justify-between gap-2", children: [
+          /* @__PURE__ */ jsx(Label, { className: "text-xs font-semibold text-slate-700", children: hopcField.fieldDef?.label ?? "History of presenting complaint" }),
+          /* @__PURE__ */ jsxs("div", { className: "flex items-center gap-2", children: [
+            hopcNarrativeLocked ? /* @__PURE__ */ jsxs("span", { className: "rounded bg-amber-50 px-1.5 py-0.5 text-[10px] font-medium text-amber-900 ring-1 ring-amber-200/80", children: [
+              "You edited this summary. Use",
+              " ",
+              /* @__PURE__ */ jsx("span", { className: "italic", children: "'Regenerate'" }),
+              " ",
+              "to update it from the form."
+            ] }) : null,
+            hopcNarrativeLocked ? /* @__PURE__ */ jsx(
+              Button,
+              {
+                type: "button",
+                variant: "outline",
+                size: "sm",
+                className: "h-7 shrink-0 px-2 text-xs",
+                disabled: disabled || hopcField.disabled,
+                onClick: () => {
+                  setHopcNarrativeLocked(false);
+                  hopcField.setValue(
+                    formatGeneralSurgerySmartHistoryToNarrative(
+                      normalizeGeneralSurgerySmartHistory(value),
+                      chips
+                    )
+                  );
+                },
+                children: "Regenerate"
+              }
+            ) : null
+          ] })
+        ] }),
+        hopcNarrativeLocked ? /* @__PURE__ */ jsx("p", { className: "text-[10px] text-muted-foreground", children: "Edit this box anytime. Use Regenerate to replace with fresh text from the structured fields." }) : null,
         /* @__PURE__ */ jsx(
           Textarea,
           {
-            className: "min-h-[72px] rounded-md border border-input bg-white text-sm",
-            placeholder: "Fever, weight loss, appetite loss, fatigue, malignancy red flags\u2026",
-            value: safe.systemic,
-            onChange: (e) => update({ ...safe, systemic: e.target.value }),
-            disabled
+            className: "min-h-[88px] rounded-md border border-input bg-white text-sm",
+            placeholder: "Onset, progression, associated symptoms, relevant negatives\u2026",
+            value: typeof hopcField.value === "string" ? hopcField.value : hopcField.value == null ? "" : String(hopcField.value),
+            onChange: (e) => {
+              setHopcNarrativeLocked(true);
+              hopcField.setValue(e.target.value);
+              hopcField.setTouched();
+            },
+            disabled: disabled || hopcField.disabled
           }
         )
       ] })
@@ -9611,12 +9943,72 @@ function RegionCard({ title, children }) {
     /* @__PURE__ */ jsx("div", { className: "p-3", children })
   ] });
 }
+var BREAST_TEXT_KEYS = [
+  { key: "size", label: "Size" },
+  { key: "quadrant", label: "Quadrant" },
+  { key: "tenderness", label: "Tenderness" },
+  { key: "fixity", label: "Fixity" },
+  { key: "skinInvolvement", label: "Skin involvement" },
+  { key: "consistency", label: "Consistency" }
+];
+function BreastLumpColumn({
+  title,
+  data,
+  onChange,
+  disabled
+}) {
+  return /* @__PURE__ */ jsxs("div", { className: "space-y-2 rounded-md border border-[#D0D0D0] bg-slate-50/50 p-3", children: [
+    /* @__PURE__ */ jsx("p", { className: "text-[11px] font-semibold uppercase tracking-wide text-muted-foreground", children: title }),
+    /* @__PURE__ */ jsx("div", { className: "grid grid-cols-1 gap-2 sm:grid-cols-2", children: BREAST_TEXT_KEYS.map(({ key, label }) => /* @__PURE__ */ jsxs("label", { className: "block", children: [
+      /* @__PURE__ */ jsx("span", { className: "mb-1 block font-medium", children: label }),
+      /* @__PURE__ */ jsx(
+        Input,
+        {
+          className: "h-8 text-xs",
+          value: data[key],
+          onChange: (e) => onChange({ [key]: e.target.value }),
+          disabled
+        }
+      )
+    ] }, key)) }),
+    /* @__PURE__ */ jsxs("div", { className: "flex flex-wrap gap-x-4 gap-y-2 pt-1", children: [
+      /* @__PURE__ */ jsxs("label", { className: "flex items-center gap-2", children: [
+        /* @__PURE__ */ jsx(
+          Checkbox,
+          {
+            checked: data.axillaryNodes,
+            onCheckedChange: (c) => onChange({ axillaryNodes: c === true }),
+            disabled
+          }
+        ),
+        "Axillary nodes"
+      ] }),
+      /* @__PURE__ */ jsxs("label", { className: "flex items-center gap-2", children: [
+        /* @__PURE__ */ jsx(
+          Checkbox,
+          {
+            checked: data.nippleAreolarComplex,
+            onCheckedChange: (c) => onChange({ nippleAreolarComplex: c === true }),
+            disabled
+          }
+        ),
+        "Nipple-areolar complex"
+      ] })
+    ] })
+  ] });
+}
 var GsExaminationWidget = ({ fieldId }) => {
   const { fieldDef, value, setValue, setTouched, error, touched, disabled } = useField(fieldId);
   const clinicalField = useField(GS_CLINICAL_EXAMINATION_FIELD);
   const { state } = useForm();
   const showError = !!error && (touched || state.submitAttempted);
   const safe = useMemo(() => normalizeGeneralSurgeryExamination(value), [value]);
+  const [clinicalNarrativeLocked, setClinicalNarrativeLocked] = useState(false);
+  useEffect(() => {
+    if (clinicalNarrativeLocked) return;
+    const next = formatGeneralSurgeryExaminationToNarrative(normalizeGeneralSurgeryExamination(value));
+    clinicalField.setValue(next);
+  }, [value, clinicalNarrativeLocked]);
   const update = (next) => {
     setValue(next);
     setTouched();
@@ -9808,52 +10200,31 @@ var GsExaminationWidget = ({ fieldId }) => {
             "Tenderness"
           ] })
         ] }) }) : null,
-        has("breast") ? /* @__PURE__ */ jsx(RegionCard, { title: "Breast exam", children: /* @__PURE__ */ jsxs("div", { className: "grid grid-cols-1 gap-3 text-xs md:grid-cols-4", children: [
-          /* @__PURE__ */ jsxs("label", { className: "block", children: [
-            /* @__PURE__ */ jsx("span", { className: "mb-1 block font-medium", children: "Lump size (cm)" }),
-            /* @__PURE__ */ jsx(
-              Input,
-              {
-                className: "h-8 text-xs",
-                value: safe.breast.lumpSizeCm,
-                onChange: (e) => update({ ...safe, breast: { ...safe.breast, lumpSizeCm: e.target.value } }),
-                disabled
-              }
-            )
-          ] }),
-          /* @__PURE__ */ jsxs("label", { className: "flex items-center gap-2", children: [
-            /* @__PURE__ */ jsx(
-              Checkbox,
-              {
-                checked: safe.breast.mobile,
-                onCheckedChange: (c) => update({ ...safe, breast: { ...safe.breast, mobile: c === true } }),
-                disabled
-              }
-            ),
-            "Mobile"
-          ] }),
-          /* @__PURE__ */ jsxs("label", { className: "flex items-center gap-2", children: [
-            /* @__PURE__ */ jsx(
-              Checkbox,
-              {
-                checked: safe.breast.skinInvolvement,
-                onCheckedChange: (c) => update({ ...safe, breast: { ...safe.breast, skinInvolvement: c === true } }),
-                disabled
-              }
-            ),
-            "Skin involvement"
-          ] }),
-          /* @__PURE__ */ jsxs("label", { className: "flex items-center gap-2", children: [
-            /* @__PURE__ */ jsx(
-              Checkbox,
-              {
-                checked: safe.breast.axillaryNodes,
-                onCheckedChange: (c) => update({ ...safe, breast: { ...safe.breast, axillaryNodes: c === true } }),
-                disabled
-              }
-            ),
-            "Axillary nodes"
-          ] })
+        has("breast") ? /* @__PURE__ */ jsx(RegionCard, { title: "Breast exam", children: /* @__PURE__ */ jsxs("div", { className: "grid grid-cols-1 gap-4 text-xs md:grid-cols-2", children: [
+          /* @__PURE__ */ jsx(
+            BreastLumpColumn,
+            {
+              title: "Left breast",
+              data: safe.breast.left,
+              onChange: (p) => update({
+                ...safe,
+                breast: { ...safe.breast, left: { ...safe.breast.left, ...p } }
+              }),
+              disabled
+            }
+          ),
+          /* @__PURE__ */ jsx(
+            BreastLumpColumn,
+            {
+              title: "Right breast",
+              data: safe.breast.right,
+              onChange: (p) => update({
+                ...safe,
+                breast: { ...safe.breast, right: { ...safe.breast.right, ...p } }
+              }),
+              disabled
+            }
+          )
         ] }) }) : null,
         has("thyroid") ? /* @__PURE__ */ jsx(RegionCard, { title: "Thyroid exam", children: /* @__PURE__ */ jsxs("div", { className: "grid grid-cols-1 gap-3 text-xs md:grid-cols-4", children: [
           /* @__PURE__ */ jsxs("label", { className: "block", children: [
@@ -9988,13 +10359,43 @@ var GsExaminationWidget = ({ fieldId }) => {
         ] }) }) : null
       ] }),
       /* @__PURE__ */ jsxs("div", { className: "space-y-1", children: [
-        /* @__PURE__ */ jsx(Label, { className: "text-xs font-semibold text-slate-700", children: clinicalField.fieldDef?.label ?? "Clinical examination" }),
+        /* @__PURE__ */ jsxs("div", { className: "flex flex-wrap items-center justify-between gap-2", children: [
+          /* @__PURE__ */ jsx(Label, { className: "text-xs font-semibold text-slate-700", children: clinicalField.fieldDef?.label ?? "Clinical examination" }),
+          /* @__PURE__ */ jsxs("div", { className: "flex items-center gap-2", children: [
+            clinicalNarrativeLocked ? /* @__PURE__ */ jsxs("span", { className: "rounded bg-amber-50 px-1.5 py-0.5 text-[10px] font-medium text-amber-900 ring-1 ring-amber-200/80", children: [
+              "You edited this summary. Use",
+              " ",
+              /* @__PURE__ */ jsx("span", { className: "italic", children: "'Regenerate'" }),
+              " ",
+              "to update it from the form."
+            ] }) : null,
+            clinicalNarrativeLocked ? /* @__PURE__ */ jsx(
+              Button,
+              {
+                type: "button",
+                variant: "outline",
+                size: "sm",
+                className: "h-7 shrink-0 px-2 text-xs",
+                disabled: disabled || clinicalField.disabled,
+                onClick: () => {
+                  setClinicalNarrativeLocked(false);
+                  clinicalField.setValue(
+                    formatGeneralSurgeryExaminationToNarrative(normalizeGeneralSurgeryExamination(value))
+                  );
+                },
+                children: "Regenerate"
+              }
+            ) : null
+          ] })
+        ] }),
+        clinicalNarrativeLocked ? /* @__PURE__ */ jsx("p", { className: "text-[10px] text-muted-foreground", children: "Edit this box anytime. Use Regenerate to replace with fresh text from the structured examination." }) : null,
         /* @__PURE__ */ jsx(
           Textarea,
           {
             className: "min-h-[88px] rounded-md border border-input bg-white text-sm",
             value: typeof clinicalField.value === "string" ? clinicalField.value : clinicalField.value == null ? "" : String(clinicalField.value),
             onChange: (e) => {
+              setClinicalNarrativeLocked(true);
               clinicalField.setValue(e.target.value);
               clinicalField.setTouched();
             },
@@ -10008,7 +10409,7 @@ var GsExaminationWidget = ({ fieldId }) => {
 };
 var CHIEF_CHIPS_FIELD2 = "chief_complaints_chips";
 var GS_EXAMINATION_FIELD = "gs_examination";
-function chipList2(state) {
+function chipList(state) {
   const raw = state.values[CHIEF_CHIPS_FIELD2];
   return Array.isArray(raw) ? raw.filter((x) => typeof x === "string") : [];
 }
@@ -10022,7 +10423,7 @@ var GsGradingWidget = ({ fieldId }) => {
   const { state } = useForm();
   const showError = !!error && (touched || state.submitAttempted);
   const safe = useMemo(() => normalizeGeneralSurgeryGrading(value), [value]);
-  const chips = useMemo(() => chipList2(state), [state]);
+  const chips = useMemo(() => chipList(state), [state]);
   const regions = useMemo(() => regionList(state), [state]);
   const visibleRows = useMemo(() => {
     return ALL_GS_CONDITIONS.filter(
@@ -11121,7 +11522,19 @@ var ReadOnlyFieldRenderer = ({
       ].join("\n");
       return /* @__PURE__ */ jsx(ReadOnlyText, { fieldDef, value: lines });
     }
-    case "general_surgery_smart_history":
+    case "general_surgery_smart_history": {
+      const structuredDisplay = value && typeof value === "object" ? JSON.stringify(normalizeGeneralSurgerySmartHistory(value), null, 2) : value == null || value === "" ? "\u2014" : String(value);
+      const hopcDef = resolveFieldDef?.("symptoms");
+      const hopcRaw = allValues?.["symptoms"];
+      const hopcStr = typeof hopcRaw === "string" ? hopcRaw : hopcRaw != null && hopcRaw !== "" ? String(hopcRaw) : "";
+      return /* @__PURE__ */ jsxs("div", { className: "space-y-4", children: [
+        /* @__PURE__ */ jsx(ReadOnlyText, { fieldDef, value: structuredDisplay }),
+        hopcDef ? /* @__PURE__ */ jsx(ReadOnlyText, { fieldDef: hopcDef, value: hopcStr }) : hopcStr ? /* @__PURE__ */ jsxs("div", { className: "space-y-2", children: [
+          /* @__PURE__ */ jsx("p", { className: "text-sm font-medium text-gray-700", children: "History of presenting complaint" }),
+          /* @__PURE__ */ jsx("div", { className: "text-gray-900 border border-gray-200 rounded-md p-3 bg-gray-50 min-h-[2.5rem] whitespace-pre-wrap", children: hopcStr })
+        ] }) : null
+      ] });
+    }
     case "general_surgery_grading":
       return /* @__PURE__ */ jsx(
         ReadOnlyText,