\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{bee.f (bee.f)}
\pdfinfo{
  /Title (5002-case-7.pdf)
  /Creator (Cheatography)
  /Author (bee.f (bee.f))
  /Subject (5002 Case 7 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}{017075}
\definecolor{LightBackground}{HTML}{EFF6F6}
\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{5002 Case 7 Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{bee.f (bee.f)} via \textcolor{DarkBackground}{\uline{cheatography.com/180201/cs/38677/}}}
\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}bee.f (bee.f) \\
  \uline{cheatography.com/bee-f} \\
  \end{tabulary}
\vfill
\columnbreak
\begin{tabulary}{5.8cm}{L}
  \SetRowColor{FootBackground}
  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Published 23rd February, 2024.\\
   Updated 13th May, 2023.\\
   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{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Case}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{- Ongoing neck \& back pain since "whiplash" (hit overhead w/ chair) @ 15 y.o.\{\{nl\}\}- Ongoing headaches \& migraines} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Back}}\{\{nl\}\}- Between shoulder blades under scapular\{\{nl\}\}- Constant during the day \& dull\{\{nl\}\}- 3-4/10\{\{nl\}\}- Remained same since onset\{\{nl\}\}- Feels worse in the evening} \tn 
% Row Count 7 (+ 4)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Neck}}\{\{nl\}\}- From Tx spine to base of head\{\{nl\}\}- Stiff feeling\{\{nl\}\}- Worst in the evening at 5/10\{\{nl\}\}- Worse since started studying at uni \& especially over the past few weeks} \tn 
% Row Count 11 (+ 4)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{AF:}} Prolonged sitting \& prolonged exercise\{\{nl\}\}- {\bf{RF:}} Stretching from side to side\{\{nl\}\}- {\bf{AA:}} Difficult to fall asleep (not waking due to pain)} \tn 
% Row Count 15 (+ 4)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Headaches}}\{\{nl\}\}- No headaches before accident at 15 y.o.\{\{nl\}\}- No dizziness w/ headache\{\{nl\}\}- Headaches are worse at the end of the day} \tn 
% Row Count 18 (+ 3)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Extras}}\{\{nl\}\}- After initial injury: MRI of "spine" told a slight curvature; CT (brain) for concussion\{\{nl\}\}- OCP (progesterone only) since 16 y.o.\{\{nl\}\}- 10 units of alcohol / week\{\{nl\}\}- Mother: had bowel \& breast cancer\{\{nl\}\}- IBS\{\{nl\}\}- Irregular \& heavy menses} \tn 
% Row Count 24 (+ 6)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Physical Examination Findings}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{General observations}}\{\{nl\}\}- Rounded shoulders\{\{nl\}\}- Anterior head carriage\{\{nl\}\}- Scapula protraction} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Posture/stance}}\{\{nl\}\}- Toeing out on R\{\{nl\}\}- Slight scapular protraction bilaterally \& winging on L} \tn 
% Row Count 6 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Clinical tests}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{ROM}}\{\{nl\}\}- {\bf{Cx ROM:}} 75° rot bilaterally; 40° flex \& ext; 50° lat flex bilaterally\{\{nl\}\}- {\bf{Tx ROM:}} 25° rot bilaterally; 30° flex; 20° ext; 25° lat flex bilaterally} \tn 
% Row Count 4 (+ 4)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Tx region exam}}\{\{nl\}\}- {\bf{Ott sign}} (measures ROM of Tx; identifies degenerative inflammatory process): flexion 2cm; ext 0cm} \tn 
% Row Count 7 (+ 3)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{TTP}}\{\{nl\}\}- R lev scap\{\{nl\}\}- Suboccipitals bilat\{\{nl\}\}- R rhomboids\{\{nl\}\}- L scalenes\{\{nl\}\}- upper traps bilaterally\{\{nl\}\}- L Tx ES\{\{nl\}\}- SCM bilaterally\{\{nl\}\}- L masseter} \tn 
% Row Count 11 (+ 4)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Beighton's score}} (hypermobility): 2/9} \tn 
% Row Count 12 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Cx spine exam}}\{\{nl\}\}- {\bf{Max Cx compression:}} "pressure" at base of neck w/ RRE\{\{nl\}\}- {\bf{Cx distraction, Roo's, Bakody's:}} no change to symptoms\{\{nl\}\}- {\bf{Shoulder depression test:}} "tight bilaterally"; no arm symptoms} \tn 
% Row Count 17 (+ 5)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Functional screen}}\{\{nl\}\}- Poor scapula retraction\{\{nl\}\}- Poor Tx ext on Wall Angel\{\{nl\}\}- No winging on push up} \tn 
% Row Count 20 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Discussion}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Working diagnosis}}\{\{nl\}\}- Chronic WAD\{\{nl\}\}- Mechanical/MSK\{\{nl\}\}- Chronic pain of 4 yrs} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{- Mechanism of injury: most likely caused axial compression, or an element of axial compression of Cx spine\{\{nl\}\}→ dangerous mechanism of injuryw/ risk of unstable fracture \& neurological compromise\{\{nl\}\}- {\bf{Canadian C-spine rule:}} would indicate immediate imaging \& would not do any examination\{\{nl\}\}→ pt should be kept still w/ their Cx spine immobilised \& an ambulance called; hospital would x-ray, CT \& MRI} \tn 
% Row Count 11 (+ 9)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Headache Hx}}\{\{nl\}\}- Insufficient Hx\{\{nl\}\}- Cannot suggest a working diagnosis\{\{nl\}\}- Not uncommon for pts to have more than one type of headache} \tn 
% Row Count 14 (+ 3)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Management}}\{\{nl\}\}- Consider what exercises \& functional management could be beneficial\{\{nl\}\}- Co-management w/ a health psychologist} \tn 
% Row Count 17 (+ 3)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Additional questions}}\{\{nl\}\}- Is irregular \& heavy period normal for pt \& has it been checked?\{\{nl\}\}- Is there something theft does in the evening that aggravates the HA specifically?\{\{nl\}\}- Any side effects w/ OCP?\{\{nl\}\}- Has period change since taking OCP?} \tn 
% Row Count 23 (+ 6)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Learning Outcomes}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Presentation of common headaches \& those important not to miss, \& the important Hx questions that should be asked}}\{\{nl\}\}⏺ {\bf{{\emph{Common headaches:}}}}\{\{nl\}\}- {\bf{Tension-type:}} most common; dull, non-pulsating pain that's often described as a tight band around the head; mild-moderate intensity \& not aggravated by physical activity\{\{nl\}\}- {\bf{Migraine:}} recurrent, mild-severe throbbing or pulsating pain, usually one side of head; often accompanied by Sx like nausea/vomiting, sensitivity to light \& sounds (photo/phonophobia)\{\{nl\}\}- {\bf{Cluster:}} rare but extremely painful that occur in clusters/cycles; cause severe, piercing pain on one side of head, usually around eye or temple area; often accompanied by Sx like redness \& tearing of the eye, nasal congestion, \& restlessness\{\{nl\}\}⏺ {\bf{{\emph{Not to miss:}}}}\{\{nl\}\}- {\bf{Thunderclap:}} sudden \& severe, reaches its max intensity within secs-mins; can indicate potentially life-threatening condition like subarachnoid haemorrhage, cerebral venous sinus thrombosis, or ruptured aneurysm\{\{nl\}\}- {\bf{HA w/ neurological symptoms:}} any headache w/ Sx like sudden weakness or paralysis, difficulty speaking, confusion, vision changes, or seizures; may indicate serious underlying condition like stroke, meningitis, or brain tumour\{\{nl\}\}- {\bf{New-onset HA in older pts:}} \textgreater{}50 experiencing a new-onset headache; important to consider temporal arteritis (giant cell arteritis), characterised by inflammation of blood vessels; requires immediate medical attention to prevent vision loss \& other complications\{\{nl\}\}⏺ {\bf{{\emph{Important Hx questions:}}}}\{\{nl\}\}- {\bf{Description:}} quality, location, intensity, duration, \& if there are any associated Sx\{\{nl\}\}- {\bf{Headache triggers:}} such as any foods, stress, hormonal changes, or environmental factors\{\{nl\}\}- {\bf{Frequency \& pattern:}} how often HA occur, how long they last, \& about any specific patterns\{\{nl\}\}- {\bf{PMHx:}} assess relevant medical conditions like hypertension, head/neck trauma, sinus infections, or previous neurological disorders\{\{nl\}\}- {\bf{Medications \& lifestyle factors:}} medication that may contribute; sleep patterns, caffeine intake, \& stress levels\{\{nl\}\}- {\bf{FHx:}} of migraines or other headache disorders} \tn 
% Row Count 45 (+ 45)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Chronic pain, it's impact on pts, management \& prognosis}}\{\{nl\}\}⏺ {\bf{{\emph{Impact:}}}}\{\{nl\}\}- {\bf{Physical:}} limitations in physical functioning \& mobility (causing difficulties in ADLs); may result in muscle tension, fatigue, sleep disturbances, \& decreased overall quality of life\{\{nl\}\}- {\bf{Emotional:}} leads to emotional distress like frustration, anxiety, depression, irritability, \& reduced sense of control\{\{nl\}\}- {\bf{Social:}} may lead to social isolation, withdrawal from social engagements, \& challenges in maintaining employment or fulfilling family roles\{\{nl\}\}⏺ {\bf{{\emph{Management:}}}}\{\{nl\}\}- {\bf{Multidisciplinary}} approach\{\{nl\}\}- {\bf{Medications}}\{\{nl\}\}- {\bf{Physical therapy:}}\{\{nl\}\}- {\bf{Psychological interventions:}} CBT\{\{nl\}\}- {\bf{Interventional procedures:}} nerve blocks, epidural injections, or radio frequency ablation\{\{nl\}\}- {\bf{Complementary \& alternative therapies:}} acupuncture, massage therapy, relaxation techniques, mindfulness\{\{nl\}\}{\bf{{\emph{Prognosis:}}}}\{\{nl\}\}- Varies depending on underlying cause, individual factors, \& the effectiveness of treatment approaches\{\{nl\}\}- Pain elimination may not befall possible, but the goals often to improve pain control, functional ability, \& overall quality of life\{\{nl\}\}- Many pts experience significant improvements w/ comprehensive \& personalised approach\{\{nl\}\}- Co-management is crucial} \tn 
% Row Count 72 (+ 27)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Learning Outcomes (cont)}}  \tn
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{When are smear tests \& mammograms offered as screening tests in the UK}}\{\{nl\}\}- {\bf{Smear tests:}} 25-64 y.o.; every 3-5 years\{\{nl\}\}- {\bf{Mammograms:}}\{\{nl\}\}- 50-70 y.o.; every 3 yrs\{\{nl\}\}- \textgreater{}70 y.o. need to request appointments} \tn 
% Row Count 5 (+ 5)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Different types of OCPs, their indications, contraindications \& side effects:}}\{\{nl\}\}⏺ {\bf{{\emph{Combined oral contraceptive (COCs):}}}}\{\{nl\}\}- {\bf{Indications:}} Contain oestrogen \& progestin; pregnancy prevention; cycle regulation; acne treatment; prevention of ovarian \& endometrial cancer\{\{nl\}\}- {\bf{Contraindications:}} Hx of blood clots; smokers aged 35+; uncontrolled hypertension; migraine w/ aura; liver disease; known/suspected pregnancy; breast Ca; Hx of heart disease or stroke\{\{nl\}\}- {\bf{Side effects:}} nausea, breast tenderness, irregular bleeding, mood changes, \& headache\{\{nl\}\}⏺ {\bf{{\emph{Progestin-only pills (POPs):}}}}\{\{nl\}\}- {\bf{Indications:}} pregnancy prevention; breast-feeding women; migraine w/ aura; smokers over 35+\{\{nl\}\}- {\bf{Contraindications:}} known/suspecvted pregnancy, liver disease, breast Ca, Hx of blood clots, abnormal vaginal bleeding, lupus\{\{nl\}\}- {\bf{Side effects:}} irregular periods, spotting, acne, HA, weight gain} \tn 
% Row Count 24 (+ 19)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}



\end{document}