Becoming An Adult Cheat Sheet!!!

Antimicrobial Agents  - Cell wall inhibitors

Based on mode of action • divided into families based on chemical structure

 Modes of action Interference with: 

cell wall synthesis 

protein synthesis 

nucleic acid synthesis 

plasma membrane integrity 

metabolic pathway 

Inhibitors of Bacterial Cell Wall (peptidoglycan) Synthesis 

The Beta-lactam Family 

The Glycopeptides 

Peptidoglycan is composed of N-acetylglucosamine (NAG) and N-acetylmuramic acid (NAM) repeat units, and amino acids.  Each NAM is linked to peptide chain and the peptide chains are cross-linked.

β-lactams 

Includes penicillin derivatives (penams), cephalosporins (cephems), monobactams, and carbapenems.

class of broad-spectrum antibiotics containing a β-lactam ring

Bacterial transpeptidase enzymes are responsible for catalysing cross-linking of the peptide chains

β-lactam ring bind to these transpeptidases – this inhibits cross-linking between peptide chains and prevents synthesis of stable PG

Cell wall synthesis ceases and the bacterial cells eventually die due to osmotic instability or autolysis. 

Glycopeptides 

Polypeptide agents - basic structural elements amino acids 

Vancomycin: 

complexes with peptide portion of peptidoglycan’s precursor units 

vancomycin is a large hydrophilic molecule able to form hydrogen bonds with the terminal D-alanyl-D-alanine moieties of the NAM/NAG-peptides

preventing PG transglycosylation reaction – PG precursor subunits (NAG-NAM+peptide) cannot be inserted into peptidoglycan matrix;

Vancomycin also alters bacterial-cell-membrane permeability and RNA synthesis

Uses:  serious Gram positive infections e.g. MRSA wound infection

Adverse effects:

damage to auditory nerve 

hearing loss (ototoxicity) 

“Red man/neck” syndrome - rash on face, neck, upper torso 

Mind blown 😂

BELLAMY BLAKE IS GETTING HIS WIFE BACK

Lmao what did Ariana do that means she needs to get booed at Manchester?

google is free and this article does a good job of explaining but because i dont want anyone to continue to give this girl money for being shit person, here we go.

besides being a cishet white woman HEADING a PRIDE EVENT (Which is something i shouldnt need to explain why its bad.. pride is by and for lgbt people and should not be HEADLINING a cishet.) 

Racism

this is her like 5 years ago vs her now. she is a white girl wearing blackface.  and before you go “thats not blackface! thats just a tan!!!” 

this is her on stage next to nicki minaj, a black woman. she is darker than nicki minaj. this is what a tan looks like

a tan is supposed to give you a more golden sun touched look, NOT MAKE YOU LOOK LIKE A DIFFERENT RACE! (also tan is a golden/yellow brown, not a deep brown… this is not an accident)

her hair, by the way, is in fact exensions. again, making her hair thicker and darker in order to pass as a poc… she steals from black musicians too… like its not news that white people steal culture from poc then market it as a new trend but… she really takes it to a whole new level and acts as if her new look is some fucking brand she made. 

remember shen she got a tattoo for 7 rings but didnt finish it and said “oh thats just fine :)” ? 

transmisogyny

in her video “thank you next” she has a man in a dress stereotype for a trans girl, then painted said person as desperate for a date.  this is a transmisogynist caracature. she is a cishet girl. this is transphobic. end of discussion.

homophobia

shouldnt have to explain why a het girl using sexualized lesbians that look like they came out of a porno for men in a music video for views isnt ok.

etc

she ignores when everyone first tried to tell her NICELY that what she was doing is wrong but as soon as people got less than kind about it, got all guilt trippy like a 3 yr old and went “why cant we just all get along its so sd to see people hating like this :(((((( be nice :(( “ 

she is friends with Pierce Morgan (known facist) and is QUITE PUBLIC ABOUT THIS, she constantly preaches the “we should just sit down and talk to people who are flaming bigots. their bigotry is just a difference of opinions ❤️❤️❤️” which is propaganda created by, surprise, the very bigots it refers to. if we dont fight or get upset then they can continue to be horrible people without consequence. 

she is now INSISTING on headlining pride, and i have seen more homophobic people than i can count say theyre going to buy tickets to pride just to see her. let me repeat that. homophobes are going to pride to see a homophobic artist. this is disgusting. this puts every gay and trans person there in danger. actually, it puts everyone there in danger because it is a pride event and any homophobes will see you there and assume youre gay anyhow so! 

tldr: ariana grande is a racist, transphobic, homophobic white girl parading around in blackface and appropriates black, latino, and asian cultures for $$$ and uses lgbt people for views.

What Loving someone when you have anxiety is really like.

What if you know you found the one, but every minute of the day feel like you don’t deserve them because you are worthless and not believing a single thing of what they say to you, because past relationships messed you up so bad that you have trust issues. Seeing every compliment as a lie because in your head it is simply not possible for someone to look at you that way. You make up the worst scenarios in your head of them leaving you, but you are too scared to tell them because they might actually do. Waking up every single night crying because in your dreams they don’t want to be with you, like you always expected. It feels like loving me is a job not something you do because you actually love me. I worry about everything. I overreact half of the time and I push you away when I need you the most. I need constant reassurance and god I hate it so much. There is always this fear of not knowing what someone actually thinks about you because the voices in your head are screaming at the sweet words he tells you. I say ‘sorry’ 20 times a day because I actually think I insulted you in some way and the smallest arguments seem like the end of the world. I cry and panic over the smallest things and I ask if I am annoying at least 3 times a day because I believe I am. I cry every time you have to go home or when you leave because it might be the last time I get to see you even though I know that’s not true. I never expected finding the love of my life would also be one of the most painful things ever.

Ugh #2

Pros and cons of having a mental illness

Pros: nothing anybody ever tells you can really really get to you.

- professor telling you you are stupid and worthless. Dude dont worry ive been telling that myself for years

- grades telling you you suck and you should rethink being a student. Yeah yeah i know i should

- family telling you you are weird and tiring. Tell me something i dont know

Cons: literally everything else

Pregnancy - physiology

Hormones

hCG - human chorionic gonadotropin - present in blood and urine, produced by blastocyst and placenta

Low levels of hCG could mean miscarriage, ectopic pregnancy, miscalculation of dates

High levels = molar pregnancy (cells that normally form a baby dysfunction and form cysts instead), multiple pregnancy (twins etc), miscalculation of dates

Progesterone increases fat deposition in early weeks and stimulates appetite

Increased oestrogen from corpus luteum promotes mammary gland development (breasts enlarge)

And inhibits ovulation via negative feedback [OES decreases GnRH release by hypothalamus –> linhibition of FHS and LH –> no ovulation]

Relaxin (secreted by corpus luteum) softens connective tissue in preparation for labour - not specific, all joints can be affected

Peaks in early and late pregnancy

Physical changes

Blood pressure

As early as 4 weeks into pregnancy 

plasma volume increase

caused by the affects of oestrogen and progesterone on the kidneys

OES and Prg cause vasodilation 

less resistance = less pressure

Heart rate increases by 25% to compensate

stroke volume increases 

increased overall cardiac output by 50% in third trimester

Direct action of enlarged uterus:

compresses the descending aorta and inferior vena cava 

decreased venous return - less blood in means less blood out, less blood in ventricle –> reduced pressure on walls –> reduced force to exit –> reduced placental perfusion

increased aortic pressure

increased heart rate

[shouldn’t sleep on back for this reason]

Outcomes:

Fall in blood pressure (can cause collapse if serious)

Can cause foetal hypoxia even without mother symptoms

Haematological changes

red cell mass increase by 20% (renal - increased erythropoietin production in response to detection of blood oxygenation and sodium/water balance)

Plasma volume increases more than RBC count does, causing the impression of decreased haemoglobin (anaemia)

Increased tendency to clot (hypercoagulable)

due to increase in clotting factors and plasma fibrinogen

platelet production increase (however count drops due to increase in activity and consumption) - function remains normal]

WBC count may increase due to an increase in granulocytes

Respiratory changes

Increased chest diameter, diaphragmatic expression and elevation

dyspnoea common (difficulty breathing)

breathing becomes more costal (mouth) than abdominal 

mainly mediated by progesterone levels (cause bronchial and smooth muscle relaxation and hypersensitivity to CO2)

Changes to the urinary system

cardiac output increase –> increase in renal plasma flow and glomerular filtration

increase in urea, creatinine, urate and biocarbonate clearance 

with progesterone, renin and aldosterone up water retention increases

can lead to urinary stasis and increased risk of UTI

Any drugs given that are excreted renally must be given in much higher quantities consequently

Gastrointestinal changes

Appetite increase + cravings 

Gastric reflux sphincter relaxation (increased indigestion, also due to increased intra-gastric pressure (expanding uterus)) 

gallbladder dilated 

GI motility decreased and transit time slower 

albumin and protein decrease 

cholesterol twice normal value

Muskuloskeletal 

Calcium reuptake into bloodstream results in mild decalcification of bones 

relaxin softens joints (pubic symphysis + alters gait (waddling))

abdominal muscles stretch to elastic limit 

stretch marks (stria gravidarum) caused by rupture of elastic fibres and small blood vessels 

Reproductive changes

Massive increase in mass

Placenta growth (nutrition, excretion, immunity, endocrine) 

Parental blood supply 

anyway i had a really stupid idea, tag me if you end up making a character/illustration using this!

Ugh #1

Fucking up when you knew you would is so funny.

Your depression is there to tell you you are a worthless piece of shit who has to fuck other people up.

But you are ready.

Anxiety already prepared you for fucking up. 😝 you knew that would happen