\documentclass[10pt,a4paper]{article}

% Packages
\usepackage{fancyhdr}           % For header and footer
\usepackage{multicol}           % Allows multicols in tables
\usepackage{tabularx}           % Intelligent column widths
\usepackage{tabulary}           % Used in header and footer
\usepackage{hhline}             % Border under tables
\usepackage{graphicx}           % For images
\usepackage{xcolor}             % For hex colours
%\usepackage[utf8x]{inputenc}    % For unicode character support
\usepackage[T1]{fontenc}        % Without this we get weird character replacements
\usepackage{colortbl}           % For coloured tables
\usepackage{setspace}           % For line height
\usepackage{lastpage}           % Needed for total page number
\usepackage{seqsplit}           % Splits long words.
%\usepackage{opensans}          % Can't make this work so far. Shame. Would be lovely.
\usepackage[normalem]{ulem}     % For underlining links
% Most of the following are not required for the majority
% of cheat sheets but are needed for some symbol support.
\usepackage{amsmath}            % Symbols
\usepackage{MnSymbol}           % Symbols
\usepackage{wasysym}            % Symbols
%\usepackage[english,german,french,spanish,italian]{babel}              % Languages

% Document Info
\author{Ana Paula (AnaPLopes)}
\pdfinfo{
  /Title (apendicite-aguda-cirurgia.pdf)
  /Creator (Cheatography)
  /Author (Ana Paula (AnaPLopes))
  /Subject (Apendicite Aguda - Cirurgia Cheat Sheet)
}

% Lengths and widths
\addtolength{\textwidth}{6cm}
\addtolength{\textheight}{-1cm}
\addtolength{\hoffset}{-3cm}
\addtolength{\voffset}{-2cm}
\setlength{\tabcolsep}{0.2cm} % Space between columns
\setlength{\headsep}{-12pt} % Reduce space between header and content
\setlength{\headheight}{85pt} % If less, LaTeX automatically increases it
\renewcommand{\footrulewidth}{0pt} % Remove footer line
\renewcommand{\headrulewidth}{0pt} % Remove header line
\renewcommand{\seqinsert}{\ifmmode\allowbreak\else\-\fi} % Hyphens in seqsplit
% This two commands together give roughly
% the right line height in the tables
\renewcommand{\arraystretch}{1.3}
\onehalfspacing

% Commands
\newcommand{\SetRowColor}[1]{\noalign{\gdef\RowColorName{#1}}\rowcolor{\RowColorName}} % Shortcut for row colour
\newcommand{\mymulticolumn}[3]{\multicolumn{#1}{>{\columncolor{\RowColorName}}#2}{#3}} % For coloured multi-cols
\newcolumntype{x}[1]{>{\raggedright}p{#1}} % New column types for ragged-right paragraph columns
\newcommand{\tn}{\tabularnewline} % Required as custom column type in use

% Font and Colours
\definecolor{HeadBackground}{HTML}{333333}
\definecolor{FootBackground}{HTML}{666666}
\definecolor{TextColor}{HTML}{333333}
\definecolor{DarkBackground}{HTML}{48A14D}
\definecolor{LightBackground}{HTML}{F3F9F3}
\renewcommand{\familydefault}{\sfdefault}
\color{TextColor}

% Header and Footer
\pagestyle{fancy}
\fancyhead{} % Set header to blank
\fancyfoot{} % Set footer to blank
\fancyhead[L]{
\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{C}
    \SetRowColor{DarkBackground}
    \vspace{-7pt}
    {\parbox{\dimexpr\textwidth-2\fboxsep\relax}{\noindent
        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
    }
\end{tabulary}
\columnbreak
\begin{tabulary}{11cm}{L}
    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{Apendicite Aguda - Cirurgia Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{Ana Paula (AnaPLopes)} via \textcolor{DarkBackground}{\uline{cheatography.com/159248/cs/33591/}}}
\end{tabulary}
\end{multicols}}

\fancyfoot[L]{ \footnotesize
\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{LL}
  \SetRowColor{FootBackground}
  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}Ana Paula (AnaPLopes) \\
  \uline{cheatography.com/anaplopes} \\
  \end{tabulary}
\vfill
\columnbreak
\begin{tabulary}{5.8cm}{L}
  \SetRowColor{FootBackground}
  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Published 9th August, 2022.\\
   Updated 14th April, 2024.\\
   Page {\thepage} of \pageref{LastPage}.
\end{tabulary}
\vfill
\columnbreak
\begin{tabulary}{5.8cm}{L}
  \SetRowColor{FootBackground}
  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Sponsor}}  \\
  \SetRowColor{white}
  \vspace{-5pt}
  %\includegraphics[width=48px,height=48px]{dave.jpeg}
  Measure your website readability!\\
  www.readability-score.com
\end{tabulary}
\end{multicols}}




\begin{document}
\raggedright
\raggedcolumns

% Set font size to small. Switch to any value
% from this page to resize cheat sheet text:
% www.emerson.emory.edu/services/latex/latex_169.html
\footnotesize % Small font.

\begin{multicols*}{3}

\begin{tabularx}{5.377cm}{x{1.54287 cm} x{3.43413 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Exame Físico}}  \tn
% Row 0
\SetRowColor{LightBackground}
Sinal de Blumberg & Dor à descompressão brusca no ponto de McBurney (FID) \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
Sinal de Rovsing & Dor na FID ao palpar a FIE \tn 
% Row Count 5 (+ 2)
% Row 2
\SetRowColor{LightBackground}
Sinal de Lennander & Temperatura retal \textgreater{} Temperatura axilar \tn 
% Row Count 7 (+ 2)
% Row 3
\SetRowColor{white}
Sinal de Summer & Hiperestesia na FID \tn 
% Row Count 9 (+ 2)
% Row 4
\SetRowColor{LightBackground}
Sinal de Lapinski & Dor à compressão da FID ao elevar MID \tn 
% Row Count 11 (+ 2)
% Row 5
\SetRowColor{white}
Sinal de Dunphy & Dor abdominal ao tossir \tn 
% Row Count 13 (+ 2)
% Row 6
\SetRowColor{LightBackground}
Sinal do Obturador & Dor durante rotação interna passiva da coxa direita flexionada \tn 
% Row Count 16 (+ 3)
% Row 7
\SetRowColor{white}
Sinal do Psoas & Dor na flexão ativa da coxa direita contra resistência (paciente em decúbito lateral esquerdo) \tn 
% Row Count 20 (+ 4)
% Row 8
\SetRowColor{LightBackground}
Punho Percussão & Dor na FID a punho percussão do calcâneo \tn 
% Row Count 22 (+ 2)
% Row 9
\SetRowColor{white}
Sinal de Ten Horn & Dor ao tracionar testículo \tn 
% Row Count 24 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Ponto de McBurney = terço lateral em linha imaginária entre umbigo e espinha ilíaca anterossuperior; FID = Fossa Ilíaca Direita; FIE = Fossa Ilíaca Esquerda; MID = Membro Inferior Direito}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{p{0.4977 cm} x{4.4793 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Classificação Laparoscópica}}  \tn
% Row 0
\SetRowColor{LightBackground}
0 & Normal \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
1 & Hiperemia e edema \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
2 & Exsudato fibrinoso \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
3 & Necrose segmentar \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
4a & Abcesso \tn 
% Row Count 5 (+ 1)
% Row 5
\SetRowColor{white}
4b & Peritonite regional \tn 
% Row Count 6 (+ 1)
% Row 6
\SetRowColor{LightBackground}
4c & Necrose na base do apêndice \tn 
% Row Count 7 (+ 1)
% Row 7
\SetRowColor{white}
5 & Peritonite difusa \tn 
% Row Count 8 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{4{\bf{a}} = {\bf{a}}bcesso; 4{\bf{b}} = {\bf{b}}lumberg; 4{\bf{c}} = {\bf{c}}onfusão}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{p{0.4577 cm} x{1.69349 cm} x{2.42581 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{5.377cm}}{\bf\textcolor{white}{Fases}}  \tn
% Row 0
\SetRowColor{LightBackground}
I & Edematosa & Distensão e edema \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
II & \seqsplit{Úlcera-flegmosa} & Inflamação de estruturas adjacentes \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
III & \seqsplit{Fibrino-purulenta} & Abcesso (geralmente \textless{} 5cm) \tn 
% Row Count 5 (+ 2)
% Row 3
\SetRowColor{white}
IV & Perfuração ou necrose & Peritonite generalizada \tn 
% Row Count 7 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Diagnóstico}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Paciente com história típica e exame físico típico, já fecha diagnóstico clínico, não preciso de pedir qualquer exame de imagem} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Se não tiver, posso pedir exames de imagem} \tn 
% Row Count 4 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Ver adiante "Escore de Alvarado" para informações mais objetivas sobre necessidade de exame} \tn 
% Row Count 6 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Na prática, solicita-se exame de imagem na maioria das vezes} \tn 
% Row Count 8 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{TC}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Exame de imagem de escolha} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Apenas nos pacientes que não fecha critério para diagnóstico clínico} \tn 
% Row Count 3 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{USG}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Apêndice aumentado, imóvel e não compressível} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Diâmetro \textgreater{} 6mm} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Espessamento da parede do apêndice \textgreater{} 2 mm (imagem em alvo)} \tn 
% Row Count 4 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Borramento da gordura periapendicular = Hiperecogenicidade da gordura mesenterial} \tn 
% Row Count 6 (+ 2)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Visualização de fecalito} \tn 
% Row Count 7 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Líquido livre ou coleções} \tn 
% Row Count 8 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Aumento da vascularização do apêndice} \tn 
% Row Count 9 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Sem gás ou material líquido espesso no interior do apêndice} \tn 
% Row Count 11 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{1ª escolha para gestantes e crianças \newline A não visualização do apêndice na USG {\bf{não}} descarta apendicite aguda}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{p{0.4577 cm} x{2.10542 cm} x{2.01388 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{3}{x{5.377cm}}{\bf\textcolor{white}{Escore de Alvarado}}  \tn
% Row 0
\SetRowColor{LightBackground}
A & Anorexia & 1 pt \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
L & Leucocitose & 2 pt (+ 1pt se desvio a E) \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
V & Vômitos e náuseas & 1 pt \tn 
% Row Count 5 (+ 2)
% Row 3
\SetRowColor{white}
A & Algia a DB de FID & 1 pt \tn 
% Row Count 6 (+ 1)
% Row 4
\SetRowColor{LightBackground}
R & Reação febril & 1 pt \tn 
% Row Count 7 (+ 1)
% Row 5
\SetRowColor{white}
A & Algia que migra para FID & 1 pt \tn 
% Row Count 9 (+ 2)
% Row 6
\SetRowColor{LightBackground}
Do & Dor e defesa em em FID & 2 pt \tn 
% Row Count 11 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\SetRowColor{LightBackground}
\mymulticolumn{3}{x{5.377cm}}{{\bf{{\emph{PS}} - Só tem 2 que pontua 2, o 2º (leucocitose) e o que tem 2 letras (dor e defesa FID)}} \newline Estima probabilidade do paciente ter apendicite aguda \newline {\bf{1-4 pt:}} POUCO PROVÁVEL → Investigar outro diagnóstico \newline {\bf{5-6pt:}} PROVÁVEL → Pedir exame de imagem OU Observação 12 hrs (se continuar com mesmo escore após 12 hrs, cirurgia) \newline {\bf{≥7pt:}} MUITO PROVÁVEL → Cirurgia}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}---}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Apendicite em Gestantes}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Mais comum no 2º trimestre} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{No 3º trimestre tem maior risco de peritonite difusa} \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Exame de imagem: 1º USG; se ainda tiver dúvidas, solicitar RM sem contraste} \tn 
% Row Count 5 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Tratamento: apendicectomia} \tn 
% Row Count 6 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Tratamento}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Apendicectomia} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Antibiótico (associado à cirurgia): cefoxitina (apendicite não complicada) ou quinolona + metronidazol (apendicite complicada)} \tn 
% Row Count 4 (+ 3)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Se necrose alcança base do apêndice, tenho de fazer apendicectomia com sutura de Parken-Kerr (maior)} \tn 
% Row Count 7 (+ 3)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Se dor abdominal com laparotomia normal e não encontro nenhuma causa para a dor, faço apendicectomia} \tn 
% Row Count 10 (+ 3)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{5.377cm}}{Se identifiquei outra causa, não faço apendicectomia} \tn 
% Row Count 12 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}


% That's all folks
\end{multicols*}

\end{document}