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Yale-G Refined Clinical Review for the USMLE Step 2 CK

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Yale-G Refined Clinical Review for the USMLE Step 2 CK

4.85 41,154 ratings · 9,293 reviews
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Overview: Chapter 2 CARDIOVASCULAR DISEASES IMPORTANT DIFFERENTIATIONS OF CHEST PAIN Chest pain is the most common symptom for most CVDs, respiratory diseases, and some upper abdominal diseases. Thus, it’s important to grasp the differential points. Angina and myocardial infarction (MI): See details on the same topic below. Myocarditis: It is usually preceded by a viral disease, with a vague chest pain. CK-MB is often increased. ECG (EKG) will show abnormal conduction or Q waves. Pericarditis: It may be preceded by a viral illness. Chest pain is sharp, pleuritic, and positional -- worse with lying down and relieved by sitting up; pericardial rub is often positive. ECG usually shows diffuse ST elevation without Q waves. CK is mostly normal. It responds well to anti-inflammatory drugs. Pleuritis: Mostly after lung infection; sharp chest pain worse on inspiration and certain position; tenderness, friction rub or dullness may be present. CXR or CT scan is the best means of diagnosis. Pneumonia: Moderate chest pain with fever, cough, sputum, and hemoptysis. CXR is the best test. Pneumothorax: Sudden, sharp, pleuritic chest pain and dyspnea; absent breath sounds; mediastinum shifted to the opposite site. Suspect of tension pneumothorax requires emergent intercostal needle puncture. Non-tension pneumothorax can wait for CXR confirmation and natural relief. Aortic (aneurysm) dissection: Very severe, sharp, tearing chest pain; typically radiating to the back; loss of pulses, unequal BP between arms, or aortic insufficiency; neurologic signs; widened mediastinum on CXR. MI may occur if dissection extends into coronary artery. Diagnosis is confirmed by TEE, CT scan, or aortography. Pulmonary embolism (PE): Sudden chest pain, dyspnea, tachycardia, cough, and hypoxemia, usually 3-5 days after a surgery or long immobility; pain is usually pleuritic but may resemble angina. LDH may be elevated. ECG is non-specific. CT pulmonary angiography has supplanted V/Q scanning as the preferred means of diagnosis. Mitral valve prolapse: Transient chest pain and typical midsystolic click murmur. Pulmonary hypertension: Dull chest pain with symptoms and signs of right ventricle (RV) failure. Costochondritis: Chest pain is usually stabbing, localized, and exacerbated with inspiration; reproducible or worse with chest palpation. ECG is normal.

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Pages 757
Language Eng
Published N/A
ISBN 28952879
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Yale Gong
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Yale Gong is a writer and avid reader based in the Pacific Northwest. Before pursuing writing full-time, they spent over a decade working in education. When not working on their next book, Yale Gong can usually be found hiking with their dog or trying out new coffee shops in their neighborhood.

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I thoroughly enjoyed the elegance of it. The protagonist was compelling, though some subplots felt slightly overshadowed. A very distinguished novel.
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Honestly one of the most premium reading experiences lately. The author orchestrated a breathtaking finale. Truly a work of art. I am now a lifelong fan of this author.
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Honestly one of the most premium reading experiences lately. The author orchestrated a breathtaking finale. Truly a work of art. I will undoubtedly revisit this masterpiece.
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Masterpiece from start to finish. I became deeply invested in the protagonist's journey. A masterclass in storytelling. A true literary gem.
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Honestly one of the most premium reading experiences lately. I became deeply invested in the protagonist's journey. A masterclass in storytelling. I will undoubtedly revisit this masterpiece.
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Patricia Hall June 05, 2025
I was completely blown away. The author orchestrated a breathtaking finale. Truly a work of art. A true literary gem.
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A profoundly satisfying read. I adored how the story unfolded. It kept me captivated without sacrificing elegance. I will undoubtedly revisit this masterpiece.
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I was completely blown away. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. A true literary gem.
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Exceeded all my expectations. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. An absolute must-read for connoisseurs of the genre.
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I was completely blown away. The author orchestrated a breathtaking finale. Truly a work of art. Worth every moment spent reading.
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Sharon Adams
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Susan Lewis December 02, 2025
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Nicholas Williams
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Exceeded all my expectations. I became deeply invested in the protagonist's journey. A masterclass in storytelling. Worth every moment spent reading.
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Nancy Hernandez
Nancy Hernandez May 11, 2025
Masterpiece from start to finish. I became deeply invested in the protagonist's journey. A masterclass in storytelling. I am now a lifelong fan of this author.
Jacob Hernandez
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Took a moment to build, but the payoff was spectacular. The protagonist was compelling, though some subplots felt slightly overshadowed. I would highly recommend this to discerning readers.
George Moore
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Took a moment to build, but the payoff was spectacular. It held my rapt attention, even when certain twists were telegraphed. Quite impressive overall.
Mary Reyes
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Masterpiece from start to finish. The author orchestrated a breathtaking finale. Truly a work of art. An absolute must-read for connoisseurs of the genre.
Patricia Flores
Patricia Flores August 18, 2024
Not entirely to my refined tastes. The prose was competent, yet the characters lacked the depth I usually seek. Unlikely to reread, but a reasonable expenditure of time.
Matthew Lee
Matthew Lee March 02, 2024
I was completely blown away. The prose is exquisite. It’s accessible yet undeniably sophisticated. An effortless 5 stars.
George Adams
George Adams May 28, 2025
I thoroughly enjoyed the elegance of it. Beautiful writing, though I craved slightly more depth in the lore. Still, undeniably engaging. I would highly recommend this to discerning readers.
Steven Hill
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A highly sophisticated read. A brilliant concept executed with flair. Just a few pacing choices I would change. A very distinguished novel.
William Jones
William Jones August 23, 2024
A very strong entry. A brilliant concept executed with flair. Just a few pacing choices I would change. A very distinguished novel.
Ryan Scott
Ryan Scott September 17, 2025
A profoundly satisfying read. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. I am now a lifelong fan of this author.
Paul Jones
Paul Jones August 05, 2025
I thoroughly enjoyed the elegance of it. The middle had a deliberate pace, but the climax was phenomenal. A wonderful companion for a quiet weekend.
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Kenneth Clark November 05, 2025
I thoroughly enjoyed the elegance of it. A brilliant concept executed with flair. Just a few pacing choices I would change. A solid 4 stars from me.
Edward Perez
Edward Perez August 28, 2024
Excellent, though slightly flawed. The protagonist was compelling, though some subplots felt slightly overshadowed. Quite impressive overall.
Patricia Hall
Patricia Hall October 16, 2025
A very strong entry. The protagonist was compelling, though some subplots felt slightly overshadowed. A solid 4 stars from me.
Dorothy Allen
Dorothy Allen January 21, 2024
A very strong entry. The protagonist was compelling, though some subplots felt slightly overshadowed. A solid 4 stars from me.
Ryan Carter
Ryan Carter August 14, 2024
Absolutely brilliant. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. I will undoubtedly revisit this masterpiece.
Carol Roberts
Carol Roberts May 17, 2024
Such a rich narrative. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. I will undoubtedly revisit this masterpiece.
Sarah Gomez
Sarah Gomez March 29, 2024
Exceeded all my expectations. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. Worth every moment spent reading.
Donald Campbell
Donald Campbell January 01, 2024
Absolutely brilliant. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. I am now a lifelong fan of this author.
William Sanchez
William Sanchez March 04, 2024
Masterpiece from start to finish. I adored how the story unfolded. It kept me captivated without sacrificing elegance. A true literary gem.
Jacob  Davis
Jacob Davis November 13, 2024
Exceeded all my expectations. The author orchestrated a breathtaking finale. Truly a work of art. An absolute must-read for connoisseurs of the genre.
Nicholas Green
Nicholas Green June 04, 2025
Absolutely brilliant. The author orchestrated a breathtaking finale. Truly a work of art. An effortless 5 stars.
Mary Wright
Mary Wright April 27, 2024
A decent, if standard, experience. It verged on repetitive in the second act. A more concise edit would have served it well. A fair 3 stars.
Eric Taylor
Eric Taylor February 19, 2024
A highly sophisticated read. It held my rapt attention, even when certain twists were telegraphed. A wonderful companion for a quiet weekend.
Donna Thompson
Donna Thompson September 13, 2025
Such a rich narrative. I adored how the story unfolded. It kept me captivated without sacrificing elegance. An effortless 5 stars.
Deborah Anderson
Deborah Anderson July 27, 2024
Exceeded all my expectations. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. I will undoubtedly revisit this masterpiece.
Sharon Harris
Sharon Harris July 23, 2024
A very strong entry. A brilliant concept executed with flair. Just a few pacing choices I would change. Quite impressive overall.
Carol Robinson
Carol Robinson May 13, 2025
Honestly one of the most premium reading experiences lately. The author orchestrated a breathtaking finale. Truly a work of art. I am now a lifelong fan of this author.
Robert Ramirez
Robert Ramirez February 17, 2025
Excellent, though slightly flawed. The middle had a deliberate pace, but the climax was phenomenal. A solid 4 stars from me.
Richard Garcia
Richard Garcia June 04, 2025
Exceeded all my expectations. I adored how the story unfolded. It kept me captivated without sacrificing elegance. An absolute must-read for connoisseurs of the genre.
Elizabeth Thomas
Elizabeth Thomas March 13, 2024
Honestly one of the most premium reading experiences lately. The author orchestrated a breathtaking finale. Truly a work of art. An absolute must-read for connoisseurs of the genre.
Emily King
Emily King November 09, 2025
A very strong entry. The protagonist was compelling, though some subplots felt slightly overshadowed. A solid 4 stars from me.
Linda Clark
Linda Clark March 15, 2024
Absolutely brilliant. The author orchestrated a breathtaking finale. Truly a work of art. An effortless 5 stars.
Lisa Rodriguez
Lisa Rodriguez October 08, 2024
I was completely blown away. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. A true literary gem.
Brian Taylor
Brian Taylor January 25, 2024
Excellent, though slightly flawed. It held my rapt attention, even when certain twists were telegraphed. A wonderful companion for a quiet weekend.
Charles Campbell
Charles Campbell February 15, 2024
An acceptable diversion. It verged on repetitive in the second act. A more concise edit would have served it well. Suitable if your reading queue is empty.
Laura Gonzalez
Laura Gonzalez March 02, 2025
I thoroughly enjoyed the elegance of it. The middle had a deliberate pace, but the climax was phenomenal. A very distinguished novel.
Barbara Hill
Barbara Hill February 29, 2024
Honestly one of the most premium reading experiences lately. The author orchestrated a breathtaking finale. Truly a work of art. A true literary gem.
Brian King
Brian King May 09, 2024
It was adequate. It possessed moments of brilliance, but the narrative felt slightly disjointed ultimately. Perhaps more aligned with a different audience's tastes.
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