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%\usepackage{opensans}          % Can't make this work so far. Shame. Would be lovely.
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% Most of the following are not required for the majority
% of cheat sheets but are needed for some symbol support.
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\usepackage{MnSymbol}           % Symbols
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% Document Info
\author{JanePorter (janeporter)}
\pdfinfo{
  /Title (di-and-siadh.pdf)
  /Creator (Cheatography)
  /Author (JanePorter (janeporter))
  /Subject (DI and SIADH Cheat Sheet)
}

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% Commands
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% Header and Footer
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\noindent
\begin{multicols}{3}
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    {\parbox{\dimexpr\textwidth-2\fboxsep\relax}{\noindent
        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
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\begin{tabulary}{11cm}{L}
    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{DI and SIADH Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{JanePorter (janeporter)} via \textcolor{DarkBackground}{\uline{cheatography.com/120660/cs/21934/}}}
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\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{LL}
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  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}JanePorter (janeporter) \\
  \uline{cheatography.com/janeporter} \\
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\begin{tabulary}{5.8cm}{L}
  \SetRowColor{FootBackground}
  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Published 4th March, 2020.\\
   Updated 4th March, 2020.\\
   Page {\thepage} of \pageref{LastPage}.
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  %\includegraphics[width=48px,height=48px]{dave.jpeg}
  Measure your website readability!\\
  www.readability-score.com
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\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*}{2}

\begin{tabularx}{8.4cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{8.4cm}}{\bf\textcolor{white}{DI}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{{\bf{DECREASED ADH}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{{\bf{Causes:}} {\emph{Neurogenic}} - hypothalamus or pituitary lesion causes decreased synthesis, transport and release of ADH. {\emph{Nephrogenic}} - inadequate response at the kidney tubules to ADH. Results in dilute urine.} \tn 
% Row Count 6 (+ 5)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{{\bf{Signs and Symptoms:}} polydipsis, polyuria, hypernatremia, change in mental status, fatigue, weakness, hemodynamic instability.} \tn 
% Row Count 9 (+ 3)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{{\bf{Diagnosis:}} DDAVP test. A pt with neurogenic DI will respond by having an increase in urine osmolality concentration.} \tn 
% Row Count 12 (+ 3)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{{\bf{Treatment:}} {\emph{Neurogenic}} - 100-200 mU/h DDAVP with isotonic crystalloid. {\emph{Nephrogenic}} - Chlorpropamide, clofibrate and thiazide diuretics.} \tn 
% Row Count 15 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{8.4cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{8.4cm}}{\bf\textcolor{white}{SIADH}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{{\bf{INCREASED ADH RELEASE}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{{\bf{Cause:}} small cell lung carcinoma - (50\% of these pt's develop SIADH). Medications that stimulate the release of ADH: chlorpropamide (sulfonylurea), clofibrate (fibrate), thiazide diuretics, antineoplastic agents.} \tn 
% Row Count 6 (+ 5)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{{\bf{Signs and symptoms:}} Nausea, weakness, lethargy, confusion, depressed mental status, seizures} \tn 
% Row Count 8 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{{\bf{Lab values:}} hyponatremia, decreased serum osmolality, normal/increased Na+ excretion, normal/increased urine osmolality} \tn 
% Row Count 11 (+ 3)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{8.4cm}}{{\bf{Treatment:}} Surgery to treat primary malignancy. Free water restriction (500-1000mL/day). Demeclocycline: inhibits ADH at distal tubule. Convaptan: V2R antagonist (vasopressin 2 receptor). Severe hyponatremia (\textless{}115mEq): 3\% NS or 0.9\% NS with furosemide.} \tn 
% Row Count 17 (+ 6)
% Row 5
\SetRowColor{white}
\mymulticolumn{1}{x{8.4cm}}{{\bf{Anesthetic considerations:}} Replacement Na+ slowly to prevent {\emph{pontine myelinolysis}}} \tn 
% Row Count 19 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}


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

\end{document}