Nursing(Degree) · First Year · NUR101
Anatomy and Physiology
Anatomy and Physiology is one of the most important foundation courses for nursing students in Zambia. This course helps you understand how the human body is structured and how it functions, from major organs to body systems such as the nervous, cardiovascular, respiratory, and digestive …
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Anatomy and Physiology is one of the most important foundation courses for nursing students in Zambia. This course helps you understand how the human body is structured and how it functions, from major organs to body systems such as the nervous, cardiovascular, respiratory, and digestive systems. A strong grasp of this subject is essential for exams set by nursing schools and regulatory bodies in Zambia. At 25schools, we simplify complex anatomy concepts using exam-focused questions, diagrams, and clear explanations designed for nursing exams. Whether you are preparing for tests, assignments, or final examinations, this course builds the clinical understanding every successful nurse needs. Start studying with 25schools today and gain the confidence to excel in anatomy and physiology exams.
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Topic 280Coming soon
Duodenal Polyps
Duodenal polyps are less common than colorectal or gastric polyps, but have significant MALIGNANT POTENTIAL, particularly AMPULLARY and NON-AMPULLARY ADENOMAS, and are a major cause of morbidity in FAMILIAL ADENOMATOUS POLYPOSIS (FAP). For Zambian students, duodenal polyps are RARE, but important to recognize. CLASSIFICATION: NON-AMPULLARY (bulb, second part) and AMPULLARY (major duodenal papilla). EPITHELIAL: ADENOMA (tubular, villous, tubulovillous) – PREMALIGNANT. BRUNNER'S GLAND HYPERPLASIA (hamartoma, benign, submucosal). HYPERPLASTIC POLYPS (rare). NEUROENDOCRINE TUMOUR (carcinoid, gastrinoma, somatostatinoma). INFLAMMATORY FIBROID POLYP (rare). SUBEPITHELIAL: GIST, lipoma, lymphangioma, pancreatic rest. CLINICAL: ASYMPTOMATIC (incidental). LARGE ADENOMA: bleeding (anaemia), obstruction, pancreatitis (ampullary). DUODENAL ADENOMAS: SPORADIC or FAP-ASSOCIATED. FAP: 90% develop duodenal adenomas, 5-10% lifetime risk of DUODENAL/AMPULLARY ADENOCARCINOMA (leading cause of death post-colectomy). DIAGNOSIS: ENDOSCOPY (EGD) with BIOPSY. AMPULLA: SIDE-VIEWING DUODENOSCOPE, biopsy, ERCP (define biliary/pancreatic ducts). HISTOLOGY: ESSENTIAL. SPIGELMAN STAGING (FAP): based on polyp number, size, histology, dysplasia. Stages 0-IV, guides surveillance interval and intervention. MANAGEMENT: NON-AMPULLARY ADENOMA: ENDOSCOPIC RESECTION (EMR, polypectomy). SURGICAL RESECTION (segmental duodenectomy, pancreaticoduodenectomy) for LARGE (>2cm), HIGH-GRADE DYSPLASIA, INVASIVE CANCER, or NOT AMENABLE TO ENDOSCOPIC RESECTION. AMPULLARY ADENOMA: ENDOSCOPIC PAPILLECTOMY (ERCP, sphincterotomy, en bloc resection). SURGICAL: TRANSMURAL AMPULLECTOMY, PANCREATICODUODENECTOMY (Whipple) for invasive cancer. FAP DUODENAL ADENOMAS: ENDOSCOPIC SURVEILLANCE (Spigelman stage). CHEMOPREVENTION: sulindac, celecoxib (limited efficacy). SURGICAL: PROPHYLACTIC PANCREATICODUODENECTOMY for advanced (Spigelman IV), high-grade dysplasia, cancer. BRUNNER'S GLAND HYPERPLASIA: NO TREATMENT. CARCINOID: endoscopic resection (<1cm), surgical resection (>2cm, atypical). Prognosis: EXCELLENT for sporadic, small adenoma with complete resection. FAP: duodenal cancer is major cause of death. Zambian context: DUODENAL POLYPS ARE RARE. ENDOSCOPY available. AMPULLARY ADENOMA: SIDE-VIEWING DUODENOSCOPE, ERCP available (tertiary). EMR: available. PANCREATICODUODENECTOMY (Whipple): available (specialized centres). FAP: RARE. FOCUS: ENDOSCOPIC RESECTION (adenoma, non-ampullary, ampullary), SURGICAL RESECTION (large, invasive cancer, FAP with advanced polyposis). HISTOLOGY is MANDATORY.
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Coming soon
Topic 281Coming soon
Small Bowel Tumors
Small bowel tumors are RARE (<5% of GI tumours), but the small bowel accounts for >90% of GI surface area. For Zambian students, they are a DIAGNOSTIC CHALLENGE due to non-specific symptoms and difficulty in visualization. CLASSIFICATION: BENIGN (60%): ADENOMA, LEIOMYOMA, LIPOMA, HEMANGIOMA, PEUTZ-JEGHERS HAMARTOMA, INFLAMMATORY FIBROID POLYP. MALIGNANT (40%): ADENOCARCINOMA (30-40% of malignant), NEUROENDOCRINE TUMOUR (NET, carcinoid, 30-40%), LYMPHOMA (15-20%), SARCOMA (GIST, 10-15%), METASTASES (melanoma, colon, lung, breast). ADENOCARCINOMA: duodenum (periampullary) > jejunum > ileum. Risk: Crohn's disease, FAP, Lynch, celiac disease. CLINICAL: OBSTRUCTION (pain, vomiting), BLEEDING (occult, anaemia), JAUNDICE (ampullary), ABDOMINAL PAIN, WEIGHT LOSS. NET: carcinoid syndrome (flushing, diarrhoea, heart disease) if liver metastases. LYMPHOMA: B-cell (DLBCL, MALT), T-cell (EATL, celiac-associated). Present with obstruction, perforation, pain, B symptoms. GIST: see topic. DIAGNOSIS: HIGH INDEX OF SUSPICION. ENDOSCOPY: EGD (duodenum), COLONOSCOPY with ileal intubation (terminal ileum). CAPSULE ENDOSCOPY: for suspected small bowel bleeding, tumours. Limited by retention risk (obstruction). ENTEROSCOPY (double-balloon, single-balloon): diagnostic and therapeutic (biopsy, polypectomy, tattooing). CT ENTEROGRAPHY/MR ENTEROGRAPHY: best imaging modality, detects mass, mural thickening, stricture, lymphadenopathy, metastases. BIOPSY: essential. MANAGEMENT: ADENOCARCINOMA: SURGICAL RESECTION (segmental resection, pancreaticoduodenectomy). ADJUVANT CHEMOTHERAPY (fluoropyrimidine/oxaliplatin). NET: surgical resection, somatostatin analogues, PRRT. LYMPHOMA: chemotherapy (R-CHOP), surgery for complications. GIST: surgical resection, imatinib. Prognosis: ADENOCARCINOMA: 5-year survival 50% (resected), poor if metastatic. NET: indolent, 5-year survival >80% (localized). Lymphoma: good response to chemo. Zambian context: SMALL BOWEL TUMORS ARE RARE. DIAGNOSIS: LATE. CT ENTEROGRAPHY: available (tertiary). CAPSULE ENDOSCOPY: NOT AVAILABLE. ENTEROSCOPY: NOT AVAILABLE. SURGERY: resection, Whipple available. CHEMOTHERAPY: available (Cancer Hospital). IM ATINIB: available. SOMATOSTATIN ANALOGUES: available (expensive). PRRT: NOT AVAILABLE. FOCUS: SUSPECT in unexplained iron deficiency anaemia, obstruction, abdominal pain, weight loss. CT ENTEROGRAPHY. SURGICAL RESECTION. REFERRAL TO ONCOLOGY.