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% Document Info
\author{Siffi (Siffi)}
\pdfinfo{
  /Title (respiratory-conditions-1.pdf)
  /Creator (Cheatography)
  /Author (Siffi (Siffi))
  /Subject (Respiratory Conditions 1 Cheat Sheet)
}

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\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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\columnbreak
\begin{tabulary}{11cm}{L}
    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{Respiratory Conditions 1 Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{Siffi (Siffi)} via \textcolor{DarkBackground}{\uline{cheatography.com/122609/cs/29798/}}}
\end{tabulary}
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\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}Siffi (Siffi) \\
  \uline{cheatography.com/siffi} \\
  \end{tabulary}
\vfill
\columnbreak
\begin{tabulary}{5.8cm}{L}
  \SetRowColor{FootBackground}
  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Not Yet Published.\\
   Updated 6th January, 2022.\\
   Page {\thepage} of \pageref{LastPage}.
\end{tabulary}
\vfill
\columnbreak
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  \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}{Pulmonary Embolism}}  \tn
\SetRowColor{LightBackground}
\mymulticolumn{1}{p{17.67cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/siffi_1637006703_dreamstime_xxl_108468515.jpg}}} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{-Disruption of the flow of blood in the pulmonary artery due to a thrombus \newline - Part of a thrombus in the leg (DVT) breaks off and travels to the lungs \newline - Other causes = air, fat, tumour cells}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Causes}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Virchow's Triad: Hypercoagulability, venous stasis, endothelial injury} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Genetic} \tn 
% Row Count 3 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Prolonged immobilisation: Bed rest \textgreater{}3 days, \textgreater{}4 hours travel, recent orthopaedic surgery, malignanct, venous catheter, obesity, pregnancy, smoking, oral contraceptive pill} \tn 
% Row Count 7 (+ 4)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- F\# of lower limb} \tn 
% Row Count 8 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Hospitalisation for heart failure/atrial fibrillation/flutter within 3 months} \tn 
% Row Count 10 (+ 2)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Hip/knee replacement} \tn 
% Row Count 11 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Major trauma} \tn 
% Row Count 12 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Hx of previous DVT/PE} \tn 
% Row Count 13 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Central venous lines} \tn 
% Row Count 14 (+ 1)
% Row 9
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Chemotherapy} \tn 
% Row Count 15 (+ 1)
% Row 10
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Heart failure/respiratory failure} \tn 
% Row Count 16 (+ 1)
% Row 11
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Hormone replacement therapy} \tn 
% Row Count 17 (+ 1)
% Row 12
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Postpartum period} \tn 
% Row Count 18 (+ 1)
% Row 13
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Infection (UTI, pneumonia, HIV)} \tn 
% Row Count 19 (+ 1)
% Row 14
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Cancer ( Pancreatic, haemtological, lung, gastric, brain highest risk)} \tn 
% Row Count 21 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Types}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- {\bf{Haemodynamically unstable:}} PE that results in hypotension (\textless{}90mmHg) or drop of systolic blood pressure of \textgreater{}40mmHg {\bf{more likely to die from obstructive shock (severe right ventricular failure)}}} \tn 
% Row Count 4 (+ 4)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- {\bf{Haemodynamically stable}}: Small can be symptomatic/asymptomatic , mild hypotension stablises with fluid therapy or right ventricle dysfunction} \tn 
% Row Count 7 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Pathology}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Can be multiple - lower lobes more affected} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Large ones obstruct pulmonary artery, smaller ones block peripheral arteries} \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Impaired gas exchange occurs} \tn 
% Row Count 4 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Mismatch in ventilation to perfusion ratio - dead space ventilation and hypoxemia} \tn 
% Row Count 6 (+ 2)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Serotonin released - vasospasm and pulmonary flow further decreased} \tn 
% Row Count 8 (+ 2)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Inflammatory mediators - alteration of lung surfactant - hypocapnia and respiratory alkalosis} \tn 
% Row Count 10 (+ 2)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Right ventricular dilation and flattening/bowing of the interventricular septum due to increased PVR} \tn 
% Row Count 13 (+ 3)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- RBB} \tn 
% Row Count 14 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Presentation}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Dyspnea} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Pleuritic chest pain (pleural irritation)} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Cough} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Haemoptysis} \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Presyncope/syncope} \tn 
% Row Count 5 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Arrhymias} \tn 
% Row Count 6 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Haemodynamic collapse} \tn 
% Row Count 7 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Assess risk factors with Virchows triad} \tn 
% Row Count 8 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Tachypnea and Tachycardia} \tn 
% Row Count 9 (+ 1)
% Row 9
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- DVT signs (Calf \seqsplit{swelling/redness/warmness)}, palpable cords, pedal oedema, rales, decreased breath sounds, pulmonary hypertension ( elevated neck veins, loud P2, right sided gallop, right ventricular parasternal lift)} \tn 
% Row Count 14 (+ 5)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Investigations}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Arterial Blood Gas analysis - Widened alveolar-arterial gradient for oxygen, respiratory alkalosis, hypocapnia} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Brain Natriuretic Peptide (BNP) - RV pressure overload releases B-type natriuretic peptide and N-terminal - proBNP (Blood test)} \tn 
% Row Count 6 (+ 3)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Troponin - RV dysfunction} \tn 
% Row Count 7 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- D-Dimer (ELISA) - thrombotic process (high negative predictive value)} \tn 
% Row Count 9 (+ 2)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- ECG - usually nonspecific - tachycardia, nonspecific ST and T-wave changes} \tn 
% Row Count 11 (+ 2)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Chest X-ray - usually normal/nonspecific, Hamptons hump, Westermark's sign} \tn 
% Row Count 13 (+ 2)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Computed Tomographic Pulmonary Angiography (CTPA) -} \tn 
% Row Count 15 (+ 2)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{-Lung Scintigraphy} \tn 
% Row Count 16 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Pulmonary Angiography} \tn 
% Row Count 17 (+ 1)
% Row 9
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- MRA - low sensitivity, low availability} \tn 
% Row Count 18 (+ 1)
% Row 10
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- US for DVT} \tn 
% Row Count 19 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{CXR}}  \tn
\SetRowColor{LightBackground}
\mymulticolumn{1}{p{17.67cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/siffi_1637010400_Hampton_hump_bei_schwerer_Lungenembolie_-_Roe_Thorax.jpg}}} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{Left: Hampton's Hump: Dome/wedged shaped opaque  \newline Right: Westermark's sign lucency of the lung on x-ray due to lack of blood in the lung}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{CPR (Geneva)}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Previous PE/DVT - 3/1} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Heart Rate \{\{nl\}\} - 75-94 BPM - 3/1 \{\{nl\}\} - \textgreater{}95 BPM - 5/2} \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Surgery/f\# within past month - 2/1} \tn 
% Row Count 4 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Haemoptysis - 2/1} \tn 
% Row Count 5 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Active Cancer - 2/1} \tn 
% Row Count 6 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Unilateral lower limb pulses - 3/1} \tn 
% Row Count 7 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Pain on lower limb deep palpation and unilateral oedema - 4/1} \tn 
% Row Count 9 (+ 2)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Age \textgreater{}65 years - 1/1} \tn 
% Row Count 10 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{Three level score =  \newline Low /0-3/0-1 \newline Intermediate/4-10/2-4 \newline High - \textgreater{}11/\textgreater{}5 \newline  \newline Two level score:  \newline PE unlikely - 0-5/0-2 \newline PE likely - \textgreater{}6/\textgreater{}3}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Management}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{{\bf{- Send to A\&E}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Anticoagulant: Heparin then oral anticoagulant therapy} \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Prophylaxis in severe cases} \tn 
% Row Count 4 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Pneumonia}}  \tn
\SetRowColor{LightBackground}
\mymulticolumn{1}{p{17.67cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/siffi_1637182717_pneumoa.png}}} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{- Acute inflammation of and around the alveolis and terminal bronchioles - neutrophils \newline - Oedema and inflammation consolidate the affected lobe \newline - Can be \seqsplit{bacterial/viral/fungal/parasitic}}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{8.635 cm} x{8.635 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Pathogens}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Viral:}} & {\bf{Bacterial:}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
- Respiratory Syncytial Virus (RSV) & - Streptococcus pneumoniae \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
- Rhinovirus & - Haemophilis influenzae \tn 
% Row Count 5 (+ 2)
% Row 3
\SetRowColor{white}
- Influenza A,B,C (A greatest cause of mortality) & - Staphylococcus aureus \tn 
% Row Count 8 (+ 3)
% Row 4
\SetRowColor{LightBackground}
- Human Metapneumovirus (SARS) & - Group A strep \tn 
% Row Count 10 (+ 2)
% Row 5
\SetRowColor{white}
- Parainfluenza 1,2,3,4 & - Moraxella catarrhalis \tn 
% Row Count 12 (+ 2)
% Row 6
\SetRowColor{LightBackground}
- Human Bocavirus Coronavirus & - Anaerobes and aerobic gram negative bacteria \tn 
% Row Count 15 (+ 3)
% Row 7
\SetRowColor{white}
- Adenovirus & - Legionella \tn 
% Row Count 16 (+ 1)
% Row 8
\SetRowColor{LightBackground}
- Enteroviruses & - Mycoplasma pneumoniae \tn 
% Row Count 18 (+ 2)
% Row 9
\SetRowColor{white}
- Varicella-Zoster virus & - Chlamydia pneumoniae \tn 
% Row Count 20 (+ 2)
% Row 10
\SetRowColor{LightBackground}
- Hantavirus & - Chlamydia psittaci \tn 
% Row Count 21 (+ 1)
% Row 11
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Epstein-Barr (EBV)} \tn 
% Row Count 22 (+ 1)
% Row 12
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Human Herpesvirus 6 \&7} \tn 
% Row Count 23 (+ 1)
% Row 13
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Herpes simplex virus} \tn 
% Row Count 24 (+ 1)
% Row 14
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Minimi virus Cytomegalovirus (CMV)} \tn 
% Row Count 25 (+ 1)
% Row 15
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Measles} \tn 
% Row Count 26 (+ 1)
% Row 16
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- MERS (Coronavirus)} \tn 
% Row Count 27 (+ 1)
% Row 17
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Metapneumovirus} \tn 
% Row Count 28 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Causes}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Age (Young children/elderly)} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Pregnancy (usually viral)} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Immune compromised \{\{nl\}\} - Chemotherapy/Radiation \{\{nl\}\} - Immunosuppresive medications \{\{nl\}\} - HIV/AIDS \{\{nl\}\} - Inherited diseases :} \tn 
% Row Count 5 (+ 3)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Trauma/ Severe burns} \tn 
% Row Count 6 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Uncontrolled diabetes} \tn 
% Row Count 7 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Malnutrition} \tn 
% Row Count 8 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Poverty} \tn 
% Row Count 9 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Environmental exposure} \tn 
% Row Count 10 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Group living} \tn 
% Row Count 11 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{8.635 cm} x{8.635 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Presentation}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Viral:}} & {\bf{Bacterial:}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
- Gradual & - Sudden \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
- No/lower temperature & - Purulent/bloody sputum \tn 
% Row Count 4 (+ 2)
% Row 3
\SetRowColor{white}
- Hx of immunosuppression & - Temperature (\textgreater{}38C) \& increased RR (\textgreater{}18 breaths per minute) \tn 
% Row Count 7 (+ 3)
% Row 4
\SetRowColor{LightBackground}
- Hx of HIV & - Exposure to animals, crowds, water, air conditioning , aspiration \tn 
% Row Count 11 (+ 4)
% Row 5
\SetRowColor{white}
- Hx of solid organ/haemtopoietic transplantation & - \seqsplit{Tachycardia/Tachypnoea} \tn 
% Row Count 14 (+ 3)
% Row 6
\SetRowColor{LightBackground}
- Hx of neoplasm & - Chills \tn 
% Row Count 15 (+ 1)
% Row 7
\SetRowColor{white}
- Flu/GI symptoms & - Myalgia/arthralgia \tn 
% Row Count 16 (+ 1)
% Row 8
\SetRowColor{LightBackground}
- \seqsplit{Tachycardia/Tachypnea} & - Fatigue \tn 
% Row Count 18 (+ 2)
% Row 9
\SetRowColor{white}
- Usually affects lungs bilaterally & - Headache \tn 
% Row Count 20 (+ 2)
% Row 10
\SetRowColor{LightBackground}
 & - Atypical pneumonia presents with GI and altered mental state \tn 
% Row Count 24 (+ 4)
% Row 11
\SetRowColor{white}
 & - Pleuretic chest pain \tn 
% Row Count 26 (+ 2)
% Row 12
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{{\bf{Both:}} Dull on percussion, chest expansion reduced unilaterally, crackles heard on auscultation (lung bases)} \tn 
% Row Count 29 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{{\bf{Sputum:}} \newline {\bf{S.pneunomiae:}} Rust coloured \newline {\bf{Pseudomonas , haemophilius:}} Green \newline {\bf{Kiebsella:}} Red currant jelly \newline {\bf{Anaerobes:}} Foul smelling, bad tasting}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Investigations}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{{\bf{Laboratory:}}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- ELISA (viral)} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Blood cultures (not sensitive)} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- CRP, ESR} \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Urine testing} \tn 
% Row Count 5 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Sputum culture} \tn 
% Row Count 6 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{{\bf{Chest X-ray}} - can differentiate between viral and bacterial pneumonia} \tn 
% Row Count 8 (+ 2)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- {\bf{Chest CT}} - if normal chest x-ray and high suspicion of pneumonia (+ve parenchymal defects)} \tn 
% Row Count 10 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Chest X-ray}}  \tn
\SetRowColor{LightBackground}
\mymulticolumn{1}{p{17.67cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/siffi_1641494376_transfer-learning-exploits-chest-xray-to-diagnose-covid-19-pneumonia.jpg}}} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Bacterial:}}  \newline Alveolar infiltrates \newline Lobar consolidation \newline Nodular densities \newline Pleural effusion \newline {\bf{Viral:}}  \newline Interstitial infiltrates - patchy and bilateral \newline X-ray usually unremarkable}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{8.635 cm} x{8.635 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Management}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Viral:}} & {\bf{Bacterial:}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
{\bf{Influenza:}} \seqsplit{Oseltamivir/preamivir/zanamivir} & \seqsplit{Fluoroquinolone/macrolide} and beta-lactam \tn 
% Row Count 4 (+ 3)
% Row 2
\SetRowColor{LightBackground}
{\bf{RSV:}} Ribavirin & Stop smoking \tn 
% Row Count 5 (+ 1)
% Row 3
\SetRowColor{white}
{\bf{Parainfluenza:}} Ribavirin & Hydration \tn 
% Row Count 7 (+ 2)
% Row 4
\SetRowColor{LightBackground}
{\bf{HSV:}} Acyclovir & Chest physical therapy \tn 
% Row Count 9 (+ 2)
% Row 5
\SetRowColor{white}
{\bf{Adenovirus:}} Ribavirin & Upright position \tn 
% Row Count 11 (+ 2)
% Row 6
\SetRowColor{LightBackground}
{\bf{Measles:}} Ribavirin & Nutrition \tn 
% Row Count 13 (+ 2)
% Row 7
\SetRowColor{white}
{\bf{CMV:}} \seqsplit{Ganciclovir/foscarnet} & Bronchodilators \tn 
% Row Count 15 (+ 2)
% Row 8
\SetRowColor{LightBackground}
{\bf{VZ:}} Acyclovir & Pulse oximetry monitoring \tn 
% Row Count 17 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{DDx}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Any other type of pneumonia} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- \seqsplit{Bronchitis/Bronchiectasis/bronchiolitis}} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Sarcoidosis} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Amyloidosis} \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Pulmonary \seqsplit{oedema/hypertension/embolism/fibrosis}} \tn 
% Row Count 5 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Hyperreactive airway disease} \tn 
% Row Count 6 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Aspiration of a foreign body} \tn 
% Row Count 7 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Atelectasis} \tn 
% Row Count 8 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Lung abscess} \tn 
% Row Count 9 (+ 1)
% Row 9
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Respiratory failure} \tn 
% Row Count 10 (+ 1)
% Row 10
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{{\bf{If in children consider:}} Asthma , Bronchiolitis, Croup, Respiratory distress syndrome, Epiglottitis as DDx} \tn 
% Row Count 13 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{8.635 cm} x{8.635 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Prognosis}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Viral:}} & {\bf{Bacterial:}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
- Depends on virulence of the virus - hantavirus, SARS, MERS worse prognosis & - Age (\textgreater{}60 most at risk) \tn 
% Row Count 5 (+ 4)
% Row 2
\SetRowColor{LightBackground}
- Immunocompromised patient - HIV worse prognosis & - Comorbidities \tn 
% Row Count 8 (+ 3)
% Row 3
\SetRowColor{white}
- Comorbidities (COPD, CHF, Diabetes, cancer, haematological dyscrasias increase risk of death and complications) & - Antibiotic resistance of bacteria \tn 
% Row Count 14 (+ 6)
% Row 4
\SetRowColor{LightBackground}
- Presence/absence of concomitant bacterial infection & - Type of bacteria - pseudomonas, staphylococcus aureus highest mortality \tn 
% Row Count 18 (+ 4)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Time between diagnosis and treatment} \tn 
% Row Count 19 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{6.908 cm} x{10.362 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Complications}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Viral:}} & {\bf{Bacterial:}} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
- Abscess & - Respiratory failure \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
- Empyema & - Sepsis/meningitis \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
- Pleural effusion & - Multiorgan failure \tn 
% Row Count 5 (+ 2)
% Row 4
\SetRowColor{LightBackground}
- Sepsis & - Coagulopathy \tn 
% Row Count 6 (+ 1)
% Row 5
\SetRowColor{white}
- Acute respiratory failure & - Exacerbation of preexisting conditions \tn 
% Row Count 8 (+ 2)
% Row 6
\SetRowColor{LightBackground}
- Cardiovascular collapse & - Lung fibrosis \tn 
% Row Count 10 (+ 2)
% Row 7
\SetRowColor{white}
- Multiorgan failure & - Destruction of lung parenchyma \tn 
% Row Count 12 (+ 2)
% Row 8
\SetRowColor{LightBackground}
 & - Necrotising pneumona \tn 
% Row Count 13 (+ 1)
% Row 9
\SetRowColor{white}
 & - Cavitation \tn 
% Row Count 14 (+ 1)
% Row 10
\SetRowColor{LightBackground}
 & - Empyema \tn 
% Row Count 15 (+ 1)
% Row 11
\SetRowColor{white}
 & - Lung abscess \tn 
% Row Count 16 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Pleurisy}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Localised chest pain} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Inflammation of the pleura} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Can be primary or secondary} \tn 
% Row Count 3 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Pleural anatomy}}  \tn
\SetRowColor{LightBackground}
\mymulticolumn{1}{p{17.67cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/siffi_1641497189_maxresdefault.jpg}}} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{6.7353 cm} x{10.5347 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Pleural anatomy}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{- Visceral Pleura:}} & {\bf{- Parietal pleura}} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
- Surrounds lung tissue & - Lines inner chest wall \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
- Single mesothelial cells & - Contains stomata which drains pleural fluid to lymphatic capillaries in connective tissue \tn 
% Row Count 8 (+ 4)
% Row 3
\SetRowColor{white}
- No connective tissue & - Innervated by intercostal nerves (sensory) + phrenic nerve \tn 
% Row Count 11 (+ 3)
% Row 4
\SetRowColor{LightBackground}
- Supplied by vagus nerve & - Sensitive to pain \tn 
% Row Count 13 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Both are supplied by the bronchial arteries \newline - Function is to allow frictionless movement between the chest wall and chest, helps expand the lung outwards during inspiration and prevents infection into the lungs \newline - A space inbetween the visceral and parietal pleura is where the pleural fluid lies (pleural cavity)}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Causes}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{-{\bf{ Hyperacute:}} \{\{nl\}\} - Pneumothorax \{\{nl\}\} - Acute coronary syndrome \{\{nl\}\} - Pulmonary emboli \{\{nl\}\} - Acute pericarditis \{\{nl\}\} - Chest wall trauma} \tn 
% Row Count 4 (+ 4)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- {\bf{Acute:}} Viral and bacterial pneumonia} \tn 
% Row Count 5 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- {\bf{Subacute/Chronic:}} \{\{nl\}\} - RA \{\{nl\}\} - Malignancy (Metastases, pleural lymphoma, fibrous tumour, angiosarcoma, pleuropulmonary blastoma, synovial sarcoma, mesothelioma) \{\{nl\}\} - Tuberculosis} \tn 
% Row Count 9 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Presentation}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Sharp and localised thoracic/shoulder pain} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Exacerbated by coughing, sneezing, chest wall/trunk movement} \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Can be dull, achy, burning or "catching"} \tn 
% Row Count 4 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Travel hx, alcohol use, tobacco/e-cig/drug use} \tn 
% Row Count 5 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- +ve Friction rub in inspiration on auscultation (pericardial friction rub heard on both inspiration and expiration)} \tn 
% Row Count 8 (+ 3)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Dullness to percussion} \tn 
% Row Count 9 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Diminished breath sounds} \tn 
% Row Count 10 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Vocal/tactile resonance} \tn 
% Row Count 11 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Investigations}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- If pleurisy left sided {\bf{acute coronary syndrome should be ruled out}}} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- ECG, serum troponin} \tn 
% Row Count 3 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Rule out acute pericarditis and aortic dissection} \tn 
% Row Count 5 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Blood count, serum protein, albumin, lactate dehydrogenase, serum lipase (if acute pancreatitis suspected)} \tn 
% Row Count 8 (+ 3)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Sample of pleural fluid if effusion present (pH, Glucose, cell count, lactate dehydrogenase, bacterial gram stain and cultures)} \tn 
% Row Count 11 (+ 3)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Chest x-ray/CT} \tn 
% Row Count 12 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Management}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Treat underlying cause} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Drainage of the fluid to relieve pressure on the lungs} \tn 
% Row Count 3 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{DDx}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Acute coronary syndrome} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Aortic dissection} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Pneumothorax} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Pericardial effusion/tamponade} \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- PE} \tn 
% Row Count 5 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Intrathoracic malignancies} \tn 
% Row Count 6 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Infection in the lung} \tn 
% Row Count 7 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Pericarditis} \tn 
% Row Count 8 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Pleural Effusion}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Accumulation of fluid between parietal and visceral pleura (pleural cavity)} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Fluid maintained by oncotic and hydrostatic pressure and lymph drainage} \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Pleural fluid can build up if one or more of the processes above is disturbed} \tn 
% Row Count 6 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Causes}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Fluid can be transudate and exudate} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- {\bf{Exudate if:}} \{\{nl\}\} - Fluid protein/serum protein ratio \textgreater{}0.5 \{\{nl\}\} - Lactate dehydrogenase(LDH)/serum LDH ratio \textgreater{}0.6 \{\{nl\}\} - Serum LDH \textgreater{}2/3 of upper limits of normal} \tn 
% Row Count 5 (+ 4)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- {\bf{Exudate causes:}} Pulmonary infections, malignancy, inflammatory disorders (pancreatitis, lupus, RA, post-cardiac injury syndrome, chylothorax, haemothorax, benign asbestos pleural effusion) , PE, drug induced, post-radiotherapy, oesphageal rupture, ovarian hyperstimulation syndrome (increased hydrostatic pressure)} \tn 
% Row Count 12 (+ 7)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- {\bf{Transudates:}} Congestive left heart failure, nephrotic syndrome, liver cirrhoris, hypoalbuminemia (disturbance of hydrostatic/oncotic pressure)} \tn 
% Row Count 15 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Presentation}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Usually asymptomatic} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Exertional breathlessness} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Fullness of intercostal spaces} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Dullness on percussion} \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Decreased breath sounds on auscultation} \tn 
% Row Count 5 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Decreased tactile and vocal fremitus} \tn 
% Row Count 6 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Pleural rub} \tn 
% Row Count 7 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Look for underlying causes} \tn 
% Row Count 8 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Mediastinal shift (deviated trachea and apex beat)} \tn 
% Row Count 10 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Investigations}}  \tn
\SetRowColor{LightBackground}
\mymulticolumn{1}{p{17.67cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/siffi_1641503958_effusion-left.jpg}}} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{- Chest X-ray : Meniscus sign (fluid located in costophrenic angle) + mediastinal shift towards contralateral chest cavity, displacement of trachea ipsilaterally \newline - CT if malignancy \newline - Ultrasound of chest more sensitive \newline - Fluid analysis (pH, protein, albumin, LDH, glucose, cell count, gram stain, culture, cytology) \newline - Adenosine Deaminase (ADA) - Tuberculosis}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Management}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Addressing underlying cause} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Tube drainage + antibiotics} \tn 
% Row Count 2 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{DDx}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Congestive Heart Failure} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Diaphragm injury/paralysis} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Malignant mesothelioma} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Pneumonia} \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Atelectasis} \tn 
% Row Count 5 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Prognosis}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Depends on the cause} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Malignant causes have very poor prognosis (deceased within 12-24 months)} \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Recurrent effusions should be drained} \tn 
% Row Count 4 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Large effusions should not be drained too quickly due to the risk of re-expansion pulmonary oedema} \tn 
% Row Count 6 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Pneumothorax}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Air accumulates between parietal and visceral pleura} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Can apply pressure onto the lung and cause a collapse} \tn 
% Row Count 4 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Causes/Risk factors}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Can be sudden/traumatic (blunt/penetrating)} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{{\bf{Primary spontaneous causes/Risk factors:}}} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Smoking} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Tall, thin, young men} \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Pregnancy} \tn 
% Row Count 5 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Marfan syndrome} \tn 
% Row Count 6 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Familial} \tn 
% Row Count 7 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{{\bf{Secondary spontaneous:}}} \tn 
% Row Count 8 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- COPD} \tn 
% Row Count 9 (+ 1)
% Row 9
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Asthma} \tn 
% Row Count 10 (+ 1)
% Row 10
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- HIV + pneumocystis pneumonia} \tn 
% Row Count 11 (+ 1)
% Row 11
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Necrotising pneumonia} \tn 
% Row Count 12 (+ 1)
% Row 12
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Tuberculosis} \tn 
% Row Count 13 (+ 1)
% Row 13
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Sarcoidosis} \tn 
% Row Count 14 (+ 1)
% Row 14
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Cystic fibrosis} \tn 
% Row Count 15 (+ 1)
% Row 15
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Bronchogenic carcinoma} \tn 
% Row Count 16 (+ 1)
% Row 16
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Idiopathic pulmonary fibrosis} \tn 
% Row Count 17 (+ 1)
% Row 17
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Severe ARDs} \tn 
% Row Count 18 (+ 1)
% Row 18
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Langerhans cell histiocytosis} \tn 
% Row Count 19 (+ 1)
% Row 19
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Lymphangioleiomyomatosis} \tn 
% Row Count 20 (+ 1)
% Row 20
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Collagen vascular disease} \tn 
% Row Count 21 (+ 1)
% Row 21
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Cocaine/marijuana} \tn 
% Row Count 22 (+ 1)
% Row 22
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Thoracic endometriosis} \tn 
% Row Count 23 (+ 1)
% Row 23
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{{\bf{Iatrogenic:}}} \tn 
% Row Count 24 (+ 1)
% Row 24
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Pleural/transthoracic lung biopsy} \tn 
% Row Count 25 (+ 1)
% Row 25
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Central venous catheter insertion} \tn 
% Row Count 26 (+ 1)
% Row 26
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Tracheostomy} \tn 
% Row Count 27 (+ 1)
% Row 27
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Intercostal nerve block} \tn 
% Row Count 28 (+ 1)
% Row 28
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Positive pressure ventilation} \tn 
% Row Count 29 (+ 1)
% Row 29
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{{\bf{Traumatic:}}} \tn 
% Row Count 30 (+ 1)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Causes/Risk factors (cont)}}  \tn
% Row 30
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Penetrating/blunt trauma} \tn 
% Row Count 1 (+ 1)
% Row 31
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Positive pressure ventilation (barotrauma)} \tn 
% Row Count 2 (+ 1)
% Row 32
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Percutaneous Tracheostomy} \tn 
% Row Count 3 (+ 1)
% Row 33
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Spontaneous pneumothorax} \tn 
% Row Count 4 (+ 1)
% Row 34
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Open pneumothorax} \tn 
% Row Count 5 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Pathology}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Pressure in the pleural space is negative compared to atmospheric pressure} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Pressure in the thorax changes with pneumothorax} \tn 
% Row Count 3 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Surface tension between parietal and visceral pleurae causes the lung to expand outwards when chest wall expands} \tn 
% Row Count 6 (+ 3)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Lung usually collapses during elastic recoil} \tn 
% Row Count 7 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Air fills the space between the pleurae changing the pressure gradient} \tn 
% Row Count 9 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Presentation}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Can be asymptomatic or minimal symptoms} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Chest pain (pleuritic, sharp, severe, radiating to the ipsilateral shoulder)} \tn 
% Row Count 3 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- SOB (more severe in spontaneous secondary)} \tn 
% Row Count 4 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Can recur on the contralateral side} \tn 
% Row Count 5 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Increased respiratory rate} \tn 
% Row Count 6 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Asymmetrical lung expansion} \tn 
% Row Count 7 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Decreased tactile fremitus} \tn 
% Row Count 8 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Hyperresonant on percussion} \tn 
% Row Count 9 (+ 1)
% Row 8
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Decreased/absent breath sounds} \tn 
% Row Count 10 (+ 1)
% Row 9
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- {\bf{Tension pneumothorax:}} Tachycardia \textgreater{}134 BPM \{\{nl\}\} - Hypotension \{\{nl\}\} - Jugular venous distension \{\{nl\}\} - Cyanosis \{\{nl\}\} - Respiratory failure \{\{nl\}\} - Cardiac arrest} \tn 
% Row Count 14 (+ 4)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{DDx}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- \seqsplit{Aspiration/bacterial/viral} pneumonia} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Aortic dissection} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Myocardial infarction} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Pulmonary embolism} \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Acute pericarditis} \tn 
% Row Count 5 (+ 1)
% Row 5
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Oesophageal spasm/rupture} \tn 
% Row Count 6 (+ 1)
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Rib fracture} \tn 
% Row Count 7 (+ 1)
% Row 7
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Diaphragm injuries} \tn 
% Row Count 8 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Investigations}}  \tn
\SetRowColor{LightBackground}
\mymulticolumn{1}{p{17.67cm}}{\vspace{1px}\centerline{\includegraphics[width=5.1cm]{/web/www.cheatography.com/public/uploads/siffi_1641506694_lightbox_8eec0f10642611e8bc150faf8b5845b3-Image-5.png}}} \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{Chest X-ray/US/CT \newline Red arrows = radiolucent areas of pneumothorax \newline Yellow arrows = Displaced lung parenchyma}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Management}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Refer to GP if primary spontaneous} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- {\bf{Tension pneumothorax is considered a medical emergency send to A\&E}}} \tn 
% Row Count 3 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Prognosis}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Usually resolves on its own} \tn 
% Row Count 1 (+ 1)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- Can reoccur} \tn 
% Row Count 2 (+ 1)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Sponteneous secondary can be more deadly} \tn 
% Row Count 3 (+ 1)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- COPD and HIV higher mortality} \tn 
% Row Count 4 (+ 1)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Tension pneumothorax mortality is high} \tn 
% Row Count 5 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}



\end{document}