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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 80,859 ratings · 9,658 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 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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Andrew Campbell
Andrew Campbell March 29, 2025
Honestly one of the most premium reading experiences lately. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. A true literary gem.
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Masterpiece from start to finish. The prose is exquisite. It’s accessible yet undeniably sophisticated. An absolute must-read for connoisseurs of the genre.
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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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I was completely blown away. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. A true literary gem.
Emily Rodriguez
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Honestly one of the most premium reading experiences lately. The prose is exquisite. It’s accessible yet undeniably sophisticated. An effortless 5 stars.
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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.
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Absolutely brilliant. The author orchestrated a breathtaking finale. Truly a work of art. I am now a lifelong fan of this author.
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James Wilson June 14, 2024
I was completely blown away. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. I am now a lifelong fan of this author.
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Patricia Hernandez December 22, 2025
I was completely blown away. The prose is exquisite. It’s accessible yet undeniably sophisticated. Worth every moment spent reading.
Betty Johnson
Betty Johnson February 12, 2025
Absolutely brilliant. The author orchestrated a breathtaking finale. Truly a work of art. I am now a lifelong fan of this author.
Steven Hall
Steven Hall January 29, 2024
Such a rich narrative. The author orchestrated a breathtaking finale. Truly a work of art. An absolute must-read for connoisseurs of the genre.
Karen Gonzalez
Karen Gonzalez December 01, 2025
Excellent, though slightly flawed. The protagonist was compelling, though some subplots felt slightly overshadowed. I would highly recommend this to discerning readers.
Edward Jones
Edward Jones April 03, 2024
Excellent, though slightly flawed. The protagonist was compelling, though some subplots felt slightly overshadowed. Quite impressive overall.
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