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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 92,433 ratings · 8,160 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 the author of several novels. Originally from the East Coast, they now live in the Midwest with family. In addition to writing, Yale Gong enjoys gardening, cooking, and reading way past bedtime. Their work often explores the complexities of everyday life and human relationships.

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I thoroughly enjoyed the elegance of it. Beautiful writing, though I craved slightly more depth in the lore. Still, undeniably engaging. A very distinguished novel.
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I find myself somewhat conflicted. The tempo was somewhat languid, and I found my mind wandering. Not poor, simply average. Suitable if your reading queue is empty.
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Masterpiece from start to finish. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. An effortless 5 stars.
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Exceeded all my expectations. The author orchestrated a breathtaking finale. Truly a work of art. I am now a lifelong fan of this author.
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Sandra Rivera
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Absolutely brilliant. I became deeply invested in the protagonist's journey. A masterclass in storytelling. A true literary gem.
Dorothy Phillips
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A highly sophisticated read. It held my rapt attention, even when certain twists were telegraphed. A wonderful companion for a quiet weekend.
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I was completely blown away. I adored how the story unfolded. It kept me captivated without sacrificing elegance. Worth every moment spent reading.
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A very strong entry. The middle had a deliberate pace, but the climax was phenomenal. A very distinguished novel.
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I find myself somewhat conflicted. The tempo was somewhat languid, and I found my mind wandering. Not poor, simply average. A fair 3 stars.
Eric Gonzalez
Eric Gonzalez May 06, 2025
Excellent, though slightly flawed. It held my rapt attention, even when certain twists were telegraphed. A wonderful companion for a quiet weekend.
Mary Collins
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A very strong entry. It held my rapt attention, even when certain twists were telegraphed. A very distinguished novel.
Elizabeth Rivera
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Masterpiece from start to finish. The prose is exquisite. It’s accessible yet undeniably sophisticated. I am now a lifelong fan of this author.
Linda Scott
Linda Scott January 11, 2025
A highly sophisticated read. The protagonist was compelling, though some subplots felt slightly overshadowed. Quite impressive overall.
James Carter
James Carter June 02, 2025
A profoundly satisfying read. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. Worth every moment spent reading.
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Masterpiece from start to finish. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. I will undoubtedly revisit this masterpiece.
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A highly sophisticated read. The protagonist was compelling, though some subplots felt slightly overshadowed. I would highly recommend this to discerning readers.
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Kimberly Perez
Kimberly Perez July 14, 2025
Excellent, though slightly flawed. It held my rapt attention, even when certain twists were telegraphed. I would highly recommend this to discerning readers.
Barbara Nelson
Barbara Nelson February 19, 2025
Such a rich narrative. The author orchestrated a breathtaking finale. Truly a work of art. An absolute must-read for connoisseurs of the genre.
William Jackson
William Jackson January 15, 2024
A very strong entry. It held my rapt attention, even when certain twists were telegraphed. A wonderful companion for a quiet weekend.
Kevin Gomez
Kevin Gomez November 05, 2024
It was adequate. The prose was competent, yet the characters lacked the depth I usually seek. Perfectly average.
Kevin Garcia
Kevin Garcia April 03, 2024
Took a moment to build, but the payoff was spectacular. Beautiful writing, though I craved slightly more depth in the lore. Still, undeniably engaging. A solid 4 stars from me.
Donald Jackson
Donald Jackson April 08, 2025
Excellent, though slightly flawed. A brilliant concept executed with flair. Just a few pacing choices I would change. A very distinguished novel.
Anthony Miller
Anthony Miller October 26, 2025
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.
Betty Lopez
Betty Lopez July 16, 2025
Masterpiece from start to finish. I became deeply invested in the protagonist's journey. A masterclass in storytelling. A true literary gem.
Kimberly Wilson
Kimberly Wilson June 11, 2024
A highly sophisticated read. The protagonist was compelling, though some subplots felt slightly overshadowed. A solid 4 stars from me.
Stephanie Wilson
Stephanie Wilson February 24, 2024
I was completely blown away. The prose is exquisite. It’s accessible yet undeniably sophisticated. An effortless 5 stars.
Amanda Lee
Amanda Lee November 25, 2025
I was completely blown away. The prose is exquisite. It’s accessible yet undeniably sophisticated. An effortless 5 stars.
Steven Anderson
Steven Anderson May 27, 2024
A highly sophisticated read. Beautiful writing, though I craved slightly more depth in the lore. Still, undeniably engaging. A solid 4 stars from me.
Matthew Carter
Matthew Carter May 30, 2025
A very strong entry. It held my rapt attention, even when certain twists were telegraphed. Quite impressive overall.
Jessica Carter
Jessica Carter June 08, 2025
I thoroughly enjoyed the elegance of it. The protagonist was compelling, though some subplots felt slightly overshadowed. A solid 4 stars from me.
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Kimberly Williams August 31, 2024
I find myself somewhat conflicted. Certain acts were fascinating, while others felt like a slight endeavor to complete. Perfectly average.
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I was completely blown away. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. Worth every moment spent reading.
Lisa Perez
Lisa Perez March 09, 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.
Cynthia Anderson
Cynthia Anderson December 22, 2025
Absolutely brilliant. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. An effortless 5 stars.
Andrew Scott
Andrew Scott February 05, 2024
Not entirely to my refined tastes. Certain acts were fascinating, while others felt like a slight endeavor to complete. Unlikely to reread, but a reasonable expenditure of time.
James Flores
James Flores May 28, 2024
Exceeded all my expectations. The author orchestrated a breathtaking finale. Truly a work of art. I will undoubtedly revisit this masterpiece.
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