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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.
\usepackage{amsmath}            % Symbols
\usepackage{MnSymbol}           % Symbols
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% Document Info
\author{Nandrews}
\pdfinfo{
  /Title (thyroid-issues.pdf)
  /Creator (Cheatography)
  /Author (Nandrews)
  /Subject (Thyroid Issues Cheat Sheet)
}

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% Commands
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% Header and Footer
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\fancyhead[L]{
\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{C}
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    \vspace{-7pt}
    {\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{Thyroid Issues Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{Nandrews} via \textcolor{DarkBackground}{\uline{cheatography.com/177003/cs/36971/}}}
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\fancyfoot[L]{ \footnotesize
\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{LL}
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  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}Nandrews \\
  \uline{cheatography.com/nandrews} \\
  \end{tabulary}
\vfill
\columnbreak
\begin{tabulary}{5.8cm}{L}
  \SetRowColor{FootBackground}
  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Published 7th February, 2023.\\
   Updated 7th February, 2023.\\
   Page {\thepage} of \pageref{LastPage}.
\end{tabulary}
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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*}{3}

\begin{tabularx}{5.377cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{5.377cm}}{\bf\textcolor{white}{Pathophysiology:}}  \tn
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{Negative Feedback Loop (ex. correction of a thermostat) activated by a disturbance in homeostasis.% Row Count 2 (+ 2)
} \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}{Thyroid Gland}}  \tn
\SetRowColor{white}
\mymulticolumn{1}{x{5.377cm}}{T3- Triiodothyronine \newline % Row Count 1 (+ 1)
T4- Thyroxine \newline % Row Count 2 (+ 1)
{\bf{Purpose}}: \newline % Row Count 3 (+ 1)
1. Metabolic Process (burn calories) \newline % Row Count 4 (+ 1)
2. Cellular replacement \newline % Row Count 5 (+ 1)
3. Digestion \newline % Row Count 6 (+ 1)
4. Sympathetic Stimulation \newline % Row Count 7 (+ 1)
5. Regulate T \& HR \newline % Row Count 8 (+ 1)
6. Brain Function% Row Count 9 (+ 1)
} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{1.89126 cm} x{3.08574 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Hyperthyroidism "Fight or Flight"}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Causes}} & Graves Disease, Toxic Modular Goiter, Exogenous Hyperthyroidism (taking to much thyroid med), Thyroiditis, Excessive Iodine consumption \tn 
% Row Count 6 (+ 6)
% Row 1
\SetRowColor{white}
{\bf{S/S}} & Anxiety, increased HR, weight loss, restlessness, jittery, heat intolerance, palpitations, insomnia, increased systolic BP, hands tremor, hyperactive reflexes, possible goiter \tn 
% Row Count 14 (+ 8)
% Row 2
\SetRowColor{LightBackground}
{\bf{Graves Disease}} & Autoimmune, genetic component, production of TSI, TSI mimics TSH = increased thyroid hormone production \tn 
% Row Count 19 (+ 5)
% Row 3
\SetRowColor{white}
 & S/S: Exophthalmos, pretibial myxedema \tn 
% Row Count 21 (+ 2)
% Row 4
\SetRowColor{LightBackground}
{\bf{Treatments}} & Anti-thyroid Medications (Stop T3 \& T4 production)- Methimazole, PTU \tn 
% Row Count 24 (+ 3)
% Row 5
\SetRowColor{white}
 & Supportive- Beta Blockers \tn 
% Row Count 26 (+ 2)
% Row 6
\SetRowColor{LightBackground}
 & Glucocorticoids- inflammation/swelling \tn 
% Row Count 28 (+ 2)
% Row 7
\SetRowColor{white}
 & RAI- destroys thyroid tissue \tn 
% Row Count 30 (+ 2)
\end{tabularx}
\par\addvspace{1.3em}

\vfill
\columnbreak
\begin{tabularx}{5.377cm}{x{1.89126 cm} x{3.08574 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Hyperthyroidism "Fight or Flight" (cont)}}  \tn
% Row 8
\SetRowColor{LightBackground}
 & Thyroidectomy- total or partial \tn 
% Row Count 2 (+ 2)
% Row 9
\SetRowColor{white}
 & Potassium Iodine- blocks uptake of iodine \tn 
% Row Count 4 (+ 2)
% Row 10
\SetRowColor{LightBackground}
{\bf{Nursing Interventions}} & Monitor heart, VS, I\&O. Improve nutritional status, enhanced coped measures (quiet cool room), regulate temperature, monitor for thyroid storm \tn 
% Row Count 10 (+ 6)
% Row 11
\SetRowColor{white}
 & {\bf{Must have tracheostomy \seqsplit{tray/oxygen/suction/calcium} gluconate after thyroidectomy!}} \tn 
% Row Count 14 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{1.29402 cm} x{3.68298 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Thyroid Storm}}  \tn
% Row 0
\SetRowColor{LightBackground}
 & Life-Threatening \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
{\bf{Causes}}: & Excessive thyroid hormone release. Often with infection, trauma, DKA, pregnancy, surgery, or deep palpitation \tn 
% Row Count 5 (+ 4)
% Row 2
\SetRowColor{LightBackground}
{\bf{S/S}}: & fever, tachycardia, HTN, abdominal pain, sweating, anxiety, seizures, coma, death \tn 
% Row Count 8 (+ 3)
% Row 3
\SetRowColor{white}
{\bf{Treatment}}: & Maintain ventilation, temp, safety, seizure precautions, bed in low position, cool room, suction \tn 
% Row Count 12 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{1.29402 cm} x{3.68298 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Hypothyroidism "Rest \& Digest"}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Causes}}: & Hashimotos Thyroiditis, glucocorticoids, thyroid cancer, pituitary tumors, decreased ingestion of iodine, treatment of hyperthyroidism \tn 
% Row Count 5 (+ 5)
% Row 1
\SetRowColor{white}
 & Increased TSH= Decreased T3 \& T4 \tn 
% Row Count 7 (+ 2)
% Row 2
\SetRowColor{LightBackground}
 & Decreased TSH = Increased T3 \& T4 \tn 
% Row Count 9 (+ 2)
% Row 3
\SetRowColor{white}
{\bf{S/S}}: & Slow, fatigue, weakness, constipation, cold intolerance, fertility issues, low HR/RR/T, weight gain, depression \tn 
% Row Count 13 (+ 4)
% Row 4
\SetRowColor{LightBackground}
{\bf{Treatment}}: & Lifelong meds (ex.synthroid) on an empty stomach, don't take w/in 4 hours of GI meds (specifically calcium) \tn 
% Row Count 17 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{5.377cm}{x{1.29402 cm} x{3.68298 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{5.377cm}}{\bf\textcolor{white}{Hypothyroidism Myxedema Coma}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Causes}}: & Abrupt stopping of thyroid replacement medication \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
 & Post thyroidectomy \tn 
% Row Count 3 (+ 1)
% Row 2
\SetRowColor{LightBackground}
{\bf{S/S}}: & Early signs- depression, diminished cognitive status, lethargy, somnolence \tn 
% Row Count 6 (+ 3)
% Row 3
\SetRowColor{white}
 & Advancing signs: respiratory depression, coma, narcosis, hyponatremia, hypoglycemia, hypotension, bradycardia, and hypothermia \tn 
% Row Count 11 (+ 5)
% Row 4
\SetRowColor{LightBackground}
{\bf{Treatment}}: & REPLACE THYROID HORMONE \tn 
% Row Count 13 (+ 2)
% Row 5
\SetRowColor{white}
 & Avoid sedatives and opioids \tn 
% Row Count 14 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}


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

\end{document}