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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 22,668 ratings · 6,303 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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After spending years working in the corporate world, Yale Gong finally decided to pursue a lifelong passion for writing. They currently reside in a quiet suburb where they spend most of their time outlining new stories, reading extensively, and occasionally attempting to bake.

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Karen Hernandez April 11, 2024
A very strong entry. The protagonist was compelling, though some subplots felt slightly overshadowed. A solid 4 stars from me.
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Eric Roberts February 26, 2024
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I find myself somewhat conflicted. Certain acts were fascinating, while others felt like a slight endeavor to complete. Perhaps more aligned with a different audience's tastes.
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Matthew Diaz May 13, 2024
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I was completely blown away. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. I am now a lifelong fan of this author.
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I was completely blown away. The prose is exquisite. It’s accessible yet undeniably sophisticated. An absolute must-read for connoisseurs of the genre.
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William Cruz March 27, 2024
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Honestly one of the most premium reading experiences lately. The prose is exquisite. It’s accessible yet undeniably sophisticated. An absolute must-read for connoisseurs of the genre.
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Absolutely brilliant. The author orchestrated a breathtaking finale. Truly a work of art. I will undoubtedly revisit this masterpiece.
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James Hill March 20, 2024
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I was completely blown away. The author orchestrated a breathtaking finale. Truly a work of art. A true literary gem.
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Exceeded all my expectations. I adored how the story unfolded. It kept me captivated without sacrificing elegance. I will undoubtedly revisit this masterpiece.
James Lopez
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Took a moment to build, but the payoff was spectacular. Beautiful writing, though I craved slightly more depth in the lore. Still, undeniably engaging. I would highly recommend this to discerning readers.
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Took a moment to build, but the payoff was spectacular. A brilliant concept executed with flair. Just a few pacing choices I would change. I would highly recommend this to discerning readers.
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Masterpiece from start to finish. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. Worth every moment spent reading.
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Absolutely brilliant. I adored how the story unfolded. It kept me captivated without sacrificing elegance. I am now a lifelong fan of this author.
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I was completely blown away. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. An effortless 5 stars.
Jacob Robinson
Jacob Robinson September 05, 2024
Such a rich narrative. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. An effortless 5 stars.
Steven Campbell
Steven Campbell February 18, 2024
A highly sophisticated read. The protagonist was compelling, though some subplots felt slightly overshadowed. A wonderful companion for a quiet weekend.
Kevin Green
Kevin Green February 17, 2025
Exceeded all my expectations. I adored how the story unfolded. It kept me captivated without sacrificing elegance. Worth every moment spent reading.
Richard Gomez
Richard Gomez December 28, 2025
Masterpiece from start to finish. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. I am now a lifelong fan of this author.
Deborah Phillips
Deborah Phillips May 18, 2025
Absolutely brilliant. I adored how the story unfolded. It kept me captivated without sacrificing elegance. I am now a lifelong fan of this author.
Jessica Robinson
Jessica Robinson November 16, 2024
A profoundly satisfying read. The author orchestrated a breathtaking finale. Truly a work of art. An absolute must-read for connoisseurs of the genre.
David Diaz
David Diaz October 24, 2024
Not entirely to my refined tastes. It verged on repetitive in the second act. A more concise edit would have served it well. Perhaps more aligned with a different audience's tastes.
Lisa Nelson
Lisa Nelson July 17, 2025
Exceeded all my expectations. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. I will undoubtedly revisit this masterpiece.
Barbara Lewis
Barbara Lewis November 04, 2024
Absolutely brilliant. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. An absolute must-read for connoisseurs of the genre.
Carol Baker
Carol Baker November 11, 2024
Masterpiece from start to finish. The prose is exquisite. It’s accessible yet undeniably sophisticated. An effortless 5 stars.
Joshua Evans
Joshua Evans August 05, 2024
Excellent, though slightly flawed. The protagonist was compelling, though some subplots felt slightly overshadowed. A very distinguished novel.
Paul Collins
Paul Collins July 04, 2024
I thoroughly enjoyed the elegance of it. The protagonist was compelling, though some subplots felt slightly overshadowed. I would highly recommend this to discerning readers.
Edward Gonzalez
Edward Gonzalez February 26, 2025
A profoundly satisfying read. I adored how the story unfolded. It kept me captivated without sacrificing elegance. A true literary gem.
Paul Reyes
Paul Reyes November 11, 2025
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.
Edward Gonzalez
Edward Gonzalez August 08, 2024
A profoundly satisfying read. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. I am now a lifelong fan of this author.
Cynthia Scott
Cynthia Scott September 28, 2024
Such a rich narrative. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. A true literary gem.
Joseph Walker
Joseph Walker November 23, 2024
Excellent, though slightly flawed. Beautiful writing, though I craved slightly more depth in the lore. Still, undeniably engaging. A solid 4 stars from me.
John Anderson
John Anderson April 11, 2025
Absolutely brilliant. The author orchestrated a breathtaking finale. Truly a work of art. I am now a lifelong fan of this author.
Ryan Taylor
Ryan Taylor July 19, 2024
Honestly one of the most premium reading experiences lately. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. I will undoubtedly revisit this masterpiece.
Donald  Parker
Donald Parker May 10, 2024
Honestly one of the most premium reading experiences lately. I adored how the story unfolded. It kept me captivated without sacrificing elegance. Worth every moment spent reading.
William White
William White November 28, 2025
A profoundly satisfying read. The prose is exquisite. It’s accessible yet undeniably sophisticated. I am now a lifelong fan of this author.
Barbara Nguyen
Barbara Nguyen December 18, 2025
Honestly one of the most premium reading experiences lately. I adored how the story unfolded. It kept me captivated without sacrificing elegance. I will undoubtedly revisit this masterpiece.
Robert Perez
Robert Perez March 21, 2024
Exceeded all my expectations. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. Worth every moment spent reading.
Brian Brown
Brian Brown December 05, 2024
An acceptable diversion. The prose was competent, yet the characters lacked the depth I usually seek. A fair 3 stars.
Jennifer Roberts
Jennifer Roberts June 26, 2024
A decent, if standard, experience. The prose was competent, yet the characters lacked the depth I usually seek. Unlikely to reread, but a reasonable expenditure of time.
Richard Anderson
Richard Anderson September 07, 2025
A very strong entry. It held my rapt attention, even when certain twists were telegraphed. Quite impressive overall.
Daniel Jones
Daniel Jones August 02, 2024
A very strong entry. Beautiful writing, though I craved slightly more depth in the lore. Still, undeniably engaging. Quite impressive overall.
Jacob Clark
Jacob Clark December 03, 2024
A profoundly satisfying read. The prose is exquisite. It’s accessible yet undeniably sophisticated. Worth every moment spent reading.
Patricia Green
Patricia Green June 28, 2025
A profoundly satisfying read. The prose is exquisite. It’s accessible yet undeniably sophisticated. Worth every moment spent reading.
Barbara Adams
Barbara Adams July 21, 2024
A profoundly satisfying read. The prose is exquisite. It’s accessible yet undeniably sophisticated. I am now a lifelong fan of this author.
Richard  Davis
Richard Davis July 05, 2024
Excellent, though slightly flawed. The protagonist was compelling, though some subplots felt slightly overshadowed. A wonderful companion for a quiet weekend.
Joshua Flores
Joshua Flores May 10, 2024
Absolutely brilliant. I became deeply invested in the protagonist's journey. A masterclass in storytelling. An absolute must-read for connoisseurs of the genre.
Betty Anderson
Betty Anderson April 07, 2025
Masterpiece from start to finish. I became deeply invested in the protagonist's journey. A masterclass in storytelling. An absolute must-read for connoisseurs of the genre.
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