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  /Subject (Primary Care Cheat Sheet)
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        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
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    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{Primary Care Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{cmkf5k} via \textcolor{DarkBackground}{\uline{cheatography.com/140722/cs/29952/}}}
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  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}cmkf5k \\
  \uline{cheatography.com/cmkf5k} \\
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  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Published 1st December, 2021.\\
   Updated 28th November, 2021.\\
   Page {\thepage} of \pageref{LastPage}.
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  Measure your website readability!\\
  www.readability-score.com
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\begin{multicols*}{3}

\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{HYPERTENSION}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Symptoms}} & {\bf{Questions}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
Headaches, dizziness, tinnitus, blurred vision, epistaxis, chest discomfort, palpitations, nervousness, fatigue & Does patient check blood pressure at home? What numbers are they getting? What are the highest and lowest numbers? How often are their numbers super high? \tn 
% Row Count 9 (+ 8)
% Row 2
\SetRowColor{LightBackground}
{\bf{Complications}} & Any symptoms of HTN? \tn 
% Row Count 10 (+ 1)
% Row 3
\SetRowColor{white}
HF, CAD, MI, A Fib, aortic dissection, PAD, atherosclerosis, stroke, CKD, hypertensive nephrosclerosis, retinopathy & What medication(s) is the patient taking? Dose? How many times a day? How many days per week does the patient forget/does not have time to take their medication? \tn 
% Row Count 19 (+ 9)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Risk Factors}}} \tn 
% Row Count 20 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{Obesity, diabetes, smoking, excessive alcohol/caffeine, high sodium diet, physical inactivity, stress} \tn 
% Row Count 23 (+ 3)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Labs}}} \tn 
% Row Count 24 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{CBC, creatinine, eGFR, BMP} \tn 
% Row Count 25 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{HYPERTENSION: MEDICATIONS}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{ACEIs (lisinopril, enalapril)}} & {\bf{Thiazide diuretics (HCTZ)}} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
First-line for patients with DM, renal disease, ischaemic heart disease, and HF & Side effects: hypokalaemia, hyponatraemia, increased glucose and cholesterol \tn 
% Row Count 6 (+ 4)
% Row 2
\SetRowColor{LightBackground}
Side effects: dry cough, hyperkalaemia & \_\_\_ \tn 
% Row Count 8 (+ 2)
% Row 3
\SetRowColor{white}
Adverse effects: angioedema - STOP IMMEDIATELY & \_\_\_ \tn 
% Row Count 11 (+ 3)
% Row 4
\SetRowColor{LightBackground}
{\bf{ARBs (losartan, valsartan)}} & {\bf{Dihydropyridine CCB (amlodipine, nifedipine)}} \tn 
% Row Count 14 (+ 3)
% Row 5
\SetRowColor{white}
First-line for patients with DM, renal disease, ischaemic heart disease, and HF & Avoid in patients with HFrEF \tn 
% Row Count 18 (+ 4)
% Row 6
\SetRowColor{LightBackground}
Side effects: hyperkalaemia & Side effects: oedema, nausea, flushing, HA, GERD, gingival hyperplasia \tn 
% Row Count 22 (+ 4)
% Row 7
\SetRowColor{white}
{\bf{Nondihydropyridine CCB (diltiazem, verapamil)}} & {\bf{Beta blockers (propranolol, metoprolol)}} \tn 
% Row Count 25 (+ 3)
% Row 8
\SetRowColor{LightBackground}
Side effects: bradycardia, AV block, constipation, hyperprolactinaemia (verapamil) & Second-line therapy; used as primary drug in patients with HF, A Fib, ischaemic heart disease \tn 
% Row Count 30 (+ 5)
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\vfill
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\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{HYPERTENSION: MEDICATIONS (cont)}}  \tn
% Row 9
\SetRowColor{LightBackground}
 & Side effects: bronchoconstriction with non-cardioselective beta blockers, increased TG \tn 
% Row Count 5 (+ 5)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Many others, but these are the main ones that you are most likely to see in clinic.}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{DIABETES TYPE II}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Symptoms}} & {\bf{Questions}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
Polyuria, polydipsia, polyphagia, vision changes, poor wound healing, numbness, tingling, constipation & Does pt check their blood sugars at home? When? What are their morning numbers (before eating)? Numbers during the day? \tn 
% Row Count 7 (+ 6)
% Row 2
\SetRowColor{LightBackground}
{\bf{Labs}} & Highest and lowest blood sugars? How often? Any symptomatic low blood sugars? \tn 
% Row Count 11 (+ 4)
% Row 3
\SetRowColor{white}
A1c (every 3-6 months), BMP (renal function and electrolytes), LFTs, lipids, urine microalb/cr & If on insulin, how many units with which type of insulin? How often do they forget/are too busy to take their insulin? \tn 
% Row Count 17 (+ 6)
% Row 4
\SetRowColor{LightBackground}
{\bf{Look For}} & Numbness, tingling, etc? Vision changes? \tn 
% Row Count 19 (+ 2)
% Row 5
\SetRowColor{white}
Statin therapy regardless, ASCVD assessment for high-intensity statin & Have they seen an eye doctor in the past year? \tn 
% Row Count 23 (+ 4)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Last ophthalmology exam, podiatry} \tn 
% Row Count 24 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Physical Exam}}} \tn 
% Row Count 25 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Foot exam, acanthosis nigricans} \tn 
% Row Count 26 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{DIABETES TYPE II: TREATMENT}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Metformin}} & {\bf{Sulphonylureas}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
Enhances effect of insulin. Weight loss. & Glyburide, glimepiride, glipizide \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
Side effects: lactic acidosis, GI complaints (only when first starting, D/C), decreased B12 absorption & Increase insulin secretion \tn 
% Row Count 9 (+ 6)
% Row 3
\SetRowColor{white}
Contraindication: CKD w/ GFR \textless{}30 & Side effects: risk of hypoglycaemia, weight gain, agranulocytosis, haemolysis \tn 
% Row Count 13 (+ 4)
% Row 4
\SetRowColor{LightBackground}
\_\_\_\_\_ & Contraindications: CV comorbidity, obesity, severe renal/liver failure \tn 
% Row Count 17 (+ 4)
% Row 5
\SetRowColor{white}
{\bf{SGLT-2 Inhibitors}} & {\bf{Meglitinides}} \tn 
% Row Count 19 (+ 2)
% Row 6
\SetRowColor{LightBackground}
Canagliflozin, dapagliflozin, empagliflozin & Nateglinide, repaglinide \tn 
% Row Count 22 (+ 3)
% Row 7
\SetRowColor{white}
Increases glucose excretion with urine & Increases insulin secretion \tn 
% Row Count 24 (+ 2)
% Row 8
\SetRowColor{LightBackground}
Side effects: genital yeast infections and UTI, polyuria and dehydration, \seqsplit{DKAContraindication:} CKD, recurrent UTIs & Side effects: risk of hypoglycaemia, weight gain \tn 
% Row Count 30 (+ 6)
\end{tabularx}
\par\addvspace{1.3em}

\vfill
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\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{DIABETES TYPE II: TREATMENT (cont)}}  \tn
% Row 9
\SetRowColor{LightBackground}
Contraindication: CKD, recurrent UTIs & Contraindication: severe liver failure \tn 
% Row Count 2 (+ 2)
% Row 10
\SetRowColor{white}
{\bf{DPP-4 Inhibitors}} & {\bf{GLP-1 Agonists}} \tn 
% Row Count 3 (+ 1)
% Row 11
\SetRowColor{LightBackground}
Saxagliptin, sitagliptin & Exenatide, liraglutide \tn 
% Row Count 5 (+ 2)
% Row 12
\SetRowColor{white}
Inhibits GLP-1 degradation & Stimulates GLP-1 receptors \tn 
% Row Count 7 (+ 2)
% Row 13
\SetRowColor{LightBackground}
Side effects: GI sx, pancreatitis, URI, headache, dizziness, oedema & Side effects: pancreatitis, possible pancreatic cancer, nausea \tn 
% Row Count 11 (+ 4)
% Row 14
\SetRowColor{white}
Contraindication: liver failure, moderate to severe renal failure & Contraindications: pre-existing, sx GI motility disorders \tn 
% Row Count 15 (+ 4)
% Row 15
\SetRowColor{LightBackground}
\_\_\_\_\_ & \_\_\_\_\_\_ \tn 
% Row Count 16 (+ 1)
% Row 16
\SetRowColor{white}
\_\_\_\_\_ & \_\_\_\_\_\_ \tn 
% Row Count 17 (+ 1)
% Row 17
\SetRowColor{LightBackground}
{\bf{Rapid Acting Insulin}} & {\bf{Long-Acting Insulin}} \tn 
% Row Count 19 (+ 2)
% Row 18
\SetRowColor{white}
Lispro, aspart, glulisine & Glargine, detemir, degludec \tn 
% Row Count 21 (+ 2)
% Row 19
\SetRowColor{LightBackground}
Onset: 5-15 min, Peak: 1 hr, Duration: 3-4 hrs & Onset: 1-4 hrs, Duration: 24 hrs \tn 
% Row Count 24 (+ 3)
% Row 20
\SetRowColor{white}
Before meals & Once daily \tn 
% Row Count 25 (+ 1)
% Row 21
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Adverse Effects of Insulin}}} \tn 
% Row Count 26 (+ 1)
% Row 22
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{Hypoglycaemia, weight gain, lipodystrophy, hypokalaemia, oedema, pain/erythema at injection site} \tn 
% Row Count 28 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{CORONARY ARTERY DISEASE}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Symptoms}} & {\bf{Questions}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
Angina: Retrosternal chest pain/pressure that may radiate to the L arm, neck, jaw, or back. Pain is not affected by body position or breathing. No chest wall tenderness. Dyspnea, dizziness, palpitations, diaphoresis, n/v, syncope & Has patient had chest pain since last visit? Is it occuring more often or stable? Does nitro help relieve pain? \tn 
% Row Count 13 (+ 12)
% Row 2
\SetRowColor{LightBackground}
Stable angina: chest pain/sx \seqsplit{reproducible/predictable}, subside with rest or nitroglycerin. & Any hospitalisations since last visit? \tn 
% Row Count 18 (+ 5)
% Row 3
\SetRowColor{white}
{\bf{Things to Check For}} & Medication compliance? \tn 
% Row Count 20 (+ 2)
% Row 4
\SetRowColor{LightBackground}
ASCVD score, new ECGs, stress tests, ECHO, CT angio, coronary artery calcium (CAC) scoring, cardiac catheterisations & Any of the other symptoms besides chest pain? \tn 
% Row Count 26 (+ 6)
% Row 5
\SetRowColor{white}
Revascularisation - PCI or CABG & If they follow with cardiology, when was the last time they were seen? \tn 
% Row Count 30 (+ 4)
\end{tabularx}
\par\addvspace{1.3em}

\vfill
\columnbreak
\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{CORONARY ARTERY DISEASE (cont)}}  \tn
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Secondary Prevention}}} \tn 
% Row Count 1 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{Smoking cessation, increased physical activity, lifelonf antiplatelet therapy with aspiring or clopidogrel, treat comorbidities, lipid-lowering therapy} \tn 
% Row Count 5 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\begin{tabularx}{5.377cm}{x{2.83689 cm} x{2.14011 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{CORONARY ARTERY DISEASE: TREATMENT}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Anti-anginal Drugs}} & {\bf{Antiplatelet Agents}} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
First-line: beta-blockers & {\emph{Recommended for all patients}} \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
Second-line: CCBs, nitrates, ranolazine & Aspirin, clopidogrel \tn 
% Row Count 6 (+ 2)
% Row 3
\SetRowColor{white}
{\bf{ACEIs or ARBs}} & {\bf{Revascularisation}} \tn 
% Row Count 8 (+ 2)
% Row 4
\SetRowColor{LightBackground}
{\emph{In patients who also have HTN, DM, LVEF 40\% or \textless{}, CKD}} & CABG \tn 
% Row Count 11 (+ 3)
% Row 5
\SetRowColor{white}
Lisinopril, ramipril. Losartan, valsartan. & PCI \tn 
% Row Count 13 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
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\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{COPD \& TREATMENT}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Symptoms}} & {\bf{Complications}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
Cough, dyspnea, fatigue, hyperventilation & Chronic respiratory failure, R HF (cor pulmonale), secondary spontaneous pneumothorax \tn 
% Row Count 6 (+ 5)
% Row 2
\SetRowColor{LightBackground}
{\bf{Physical Exam}} & {\bf{Treatment}} \tn 
% Row Count 7 (+ 1)
% Row 3
\SetRowColor{white}
Accessory muscle use, barrel chest, decreased breath sounds, end-expiratory wheezing and/or prolonged expiration, rhonchi/crackles, cyanosis, tachycardia, JVD, oedema, nail clubbing & Short-acting beta agonists: salbutamol \tn 
% Row Count 17 (+ 10)
% Row 4
\SetRowColor{LightBackground}
{\bf{Labs}} & Long-acting beta agonists: salmeterol \tn 
% Row Count 19 (+ 2)
% Row 5
\SetRowColor{white}
CBC & Short-acting muscarinic antagonists: ipratropium bromide \tn 
% Row Count 22 (+ 3)
% Row 6
\SetRowColor{LightBackground}
{\bf{Things To Look For}} & Long-acting muscarinic antagonists: tiotropium bromide \tn 
% Row Count 25 (+ 3)
% Row 7
\SetRowColor{white}
PFT: FEV1 and FEV1/FVC & Inhaled corticosteroids: budesonide, fluticasone \tn 
% Row Count 28 (+ 3)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{CXR, chest CT} \tn 
% Row Count 29 (+ 1)
% Row 9
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{Pulmonology clinic notes} \tn 
% Row Count 30 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Questions: How often they use albuterol inhaler? Any hospitalisations due to COPD exacerbation since last visit? If on O2, when do they use it? How has their COPD been - stable, worse? Have they used their steroids (pills) since the last visit (if they have them, some have to prevent exacerbations)?}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
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\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{CKD}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Risk Factors}} & {\bf{Treatment}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
DMII, HTN, obesity, advanced age, substance use, AKI & Diet \tn 
% Row Count 4 (+ 3)
% Row 2
\SetRowColor{LightBackground}
{\bf{Aetiology}} & Avoidance of nephrotoxic substances: NSAIDs, antifungal, antibiotics, antivirals \tn 
% Row Count 8 (+ 4)
% Row 3
\SetRowColor{white}
Diabetic nephropathy, hypertensive nephropathy, glomerulonephritis, PKD, analgesic misuse, amyloidosis & Control underlying condition and comorbidities \tn 
% Row Count 14 (+ 6)
% Row 4
\SetRowColor{LightBackground}
{\bf{Labs}} & Haemodialysis \tn 
% Row Count 15 (+ 1)
% Row 5
\SetRowColor{white}
CBC, BMP (Cr, BUN), PT, PTT, bleeding time, lipid panel, blood pH, eGFR, urinalysis, urine microalb/cr & {\bf{Complications}} \tn 
% Row Count 21 (+ 6)
% Row 6
\SetRowColor{LightBackground}
 & CKD-mineral and bone disorder, secondary hyperparathyroidism, anaemia, ESRD \tn 
% Row Count 25 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
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\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{CONGESTIVE HEART FAILURE}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Symptoms}} & {\bf{Lifestyle Modifications}} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
Nocturia, fatigue, tachycardia, dyspnea, orthopnea, PND, peripheral oedema & Exercise, cessation of \seqsplit{smoking/EtOH/recreational} drugs, weight loss, immunisations \tn 
% Row Count 7 (+ 5)
% Row 2
\SetRowColor{LightBackground}
{\bf{Physical Exam}} & Diet and fluid restriction \tn 
% Row Count 9 (+ 2)
% Row 3
\SetRowColor{white}
S3/S4 gallop, pulsus alternans, bilateral basilar crackles, displaced apical heart beat, peripheral pitting oedema, JVD, hepatojugular reflux & Self-monitoring and symptom recognition (if pt gains \textgreater{} 4-5 lbs within 3 days -\textgreater{} fluid overloaded) \tn 
% Row Count 17 (+ 8)
% Row 4
\SetRowColor{LightBackground}
{\bf{Labs}} & {\bf{Drugs to Avoid}} \tn 
% Row Count 18 (+ 1)
% Row 5
\SetRowColor{white}
CBC, BMP, LFTs, lipid panel & Most antiarrhythmic drugs, CCB (except amlodipine), NSAIDs, thiazolidinediones \tn 
% Row Count 22 (+ 4)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Know baseline BNP} \tn 
% Row Count 23 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{{\bf{Look For}}} \tn 
% Row Count 24 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Echo - ejection fraction, valvular dysfunction} \tn 
% Row Count 25 (+ 1)
% Row 9
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{CXR - cardiac silhouette, pulmonary congestion} \tn 
% Row Count 26 (+ 1)
% Row 10
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{ECG - LVH} \tn 
% Row Count 27 (+ 1)
% Row 11
\SetRowColor{white}
\mymulticolumn{2}{x{5.377cm}}{Cardiac MRI, L heart cath/angio, R heart cath} \tn 
% Row Count 28 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{CONGESTIVE HEART FAILURE: TREATMENT}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{ACEIs}} & {\bf{Aldosterone Antagonists}} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
Enalapril, lisinopril & Spironolactone, eplerenone \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
Every patient with HFrEF & Class II-IV and LVEF \textless{}35\% \tn 
% Row Count 6 (+ 2)
% Row 3
\SetRowColor{white}
{\bf{ARBs}} & Monitor for hyperkalaemia \tn 
% Row Count 8 (+ 2)
% Row 4
\SetRowColor{LightBackground}
Losartan, valsartan & {\bf{Loop Diuretics and Thiazide Diuretics}} \tn 
% Row Count 11 (+ 3)
% Row 5
\SetRowColor{white}
{\bf{Beta Blockers}} & Loop: furosemide, torsemide \tn 
% Row Count 13 (+ 2)
% Row 6
\SetRowColor{LightBackground}
Carvedilol, metoprolol & Thiazide: HCTZ, metolazone, chlorthalidone \tn 
% Row Count 16 (+ 3)
% Row 7
\SetRowColor{white}
Add once patient is stable on ACEI/ARB and no decompensated & To treat volume overload \tn 
% Row Count 19 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{CIRRHOSIS}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Symptoms}} & {\bf{Things to Look Out For}} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
Often asymptomatic & Child-Pugh score and MELD score every 6 months along with labs \tn 
% Row Count 6 (+ 4)
% Row 2
\SetRowColor{LightBackground}
Fatigue, pruritus, yellowing of skin or eyes, n/v, increased abdomen size, gynecomastia, hypogonadism & HCC screening (q6 months) \tn 
% Row Count 12 (+ 6)
% Row 3
\SetRowColor{white}
{\bf{Physical Exam}} & {\bf{Complications}} \tn 
% Row Count 13 (+ 1)
% Row 4
\SetRowColor{LightBackground}
Jaundice, telangiectasia, caput medusae, palmar erythema, hepatomegaly, splenomegaly, ascites, asterixis & Portal HTN, ascites, spontaneous bacterial peritonitis, oesophageal variceal haemorrhage, coagulopathy, hepatic encephalopathy, hepatorenal syndrome, hepatopulmonary syndrome, HCC, portal vein thrombosis \tn 
% Row Count 24 (+ 11)
% Row 5
\SetRowColor{white}
{\bf{Labs}} & {\bf{Treatment}} \tn 
% Row Count 25 (+ 1)
% Row 6
\SetRowColor{LightBackground}
CBC, LFTs, alk phos, ammonia, PT/INR, albumin & Treat underlying condition, avoid hepatotoxic substances (EtOH, NSAIDs), routine vaccines \tn 
% Row Count 30 (+ 5)
\end{tabularx}
\par\addvspace{1.3em}

\vfill
\columnbreak
\begin{tabularx}{5.377cm}{x{2.4885 cm} x{2.4885 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{CIRRHOSIS (cont)}}  \tn
% Row 7
\SetRowColor{LightBackground}
{\bf{Imaging}} & Non-selective beta blockers (propranolol) to lower portal HTN and prevent variceal bleeding \tn 
% Row Count 5 (+ 5)
% Row 8
\SetRowColor{white}
US, CT scan & Spironolactone and furosemide for ascites and oedema \tn 
% Row Count 8 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{5.377cm}}{Aetiology is extensive: alcohol use, medications, aflatoxin, hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, parasitic infections, non-alcoholic steatohepatitis, haemochromatosis, Wilson disease, alpha-1 antitrypsin deficiency, glycogen storage disease, CF, Budd-Chiari syndrome}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}


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

\end{document}