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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 68,120 ratings · 2,436 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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Michael Lee
Michael Lee July 02, 2024
I was completely blown away. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. An absolute must-read for connoisseurs of the genre.
Andrew Rodriguez
Andrew Rodriguez June 24, 2025
Exceeded all my expectations. I became deeply invested in the protagonist's journey. A masterclass in storytelling. I am now a lifelong fan of this author.
John Young
John Young July 17, 2024
A decent, if standard, experience. The tempo was somewhat languid, and I found my mind wandering. Not poor, simply average. Perhaps more aligned with a different audience's tastes.
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Sarah Torres January 30, 2024
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Stephanie Garcia February 21, 2025
Absolutely brilliant. I became deeply invested in the protagonist's journey. A masterclass in storytelling. An effortless 5 stars.
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Andrew Johnson November 01, 2025
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William King November 28, 2025
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Jacob Clark July 16, 2024
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I was completely blown away. The author orchestrated a breathtaking finale. Truly a work of art. An absolute must-read for connoisseurs of the genre.
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Took a moment to build, but the payoff was spectacular. The middle had a deliberate pace, but the climax was phenomenal. Quite impressive overall.
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I was completely blown away. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. Worth every moment spent reading.
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Edward Young July 08, 2025
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Charles Baker April 14, 2024
A very strong entry. A brilliant concept executed with flair. Just a few pacing choices I would change. A wonderful companion for a quiet weekend.
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Exceeded all my expectations. The prose is exquisite. It’s accessible yet undeniably sophisticated. A true literary gem.
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Masterpiece from start to finish. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. I am now a lifelong fan of this author.
Ashley Garcia
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Such a rich narrative. The author orchestrated a breathtaking finale. Truly a work of art. I am now a lifelong fan of this author.
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David Turner
David Turner February 13, 2025
It was adequate. The prose was competent, yet the characters lacked the depth I usually seek. Perhaps more aligned with a different audience's tastes.
Gary  Davis
Gary Davis April 04, 2024
Honestly one of the most premium reading experiences lately. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. Worth every moment spent reading.
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A profoundly satisfying read. The author orchestrated a breathtaking finale. Truly a work of art. A true literary gem.
William Hernandez
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Masterpiece from start to finish. I adored how the story unfolded. It kept me captivated without sacrificing elegance. An absolute must-read for connoisseurs of the genre.
Robert White
Robert White March 24, 2024
Not entirely to my refined tastes. The tempo was somewhat languid, and I found my mind wandering. Not poor, simply average. Unlikely to reread, but a reasonable expenditure of time.
Stephanie Clark
Stephanie Clark June 30, 2024
Honestly one of the most premium reading experiences lately. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. Worth every moment spent reading.
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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.
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A highly sophisticated read. A brilliant concept executed with flair. Just a few pacing choices I would change. A wonderful companion for a quiet weekend.
Robert White
Robert White February 04, 2025
I thoroughly enjoyed the elegance of it. It held my rapt attention, even when certain twists were telegraphed. A very distinguished novel.
Christopher Robinson
Christopher Robinson June 13, 2024
Masterpiece from start to finish. The author orchestrated a breathtaking finale. Truly a work of art. An effortless 5 stars.
Steven Baker
Steven Baker November 22, 2024
Such a rich narrative. I adored how the story unfolded. It kept me captivated without sacrificing elegance. I will undoubtedly revisit this masterpiece.
Michael Johnson
Michael Johnson February 09, 2024
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.
Barbara  Davis
Barbara Davis June 13, 2025
A very strong entry. It held my rapt attention, even when certain twists were telegraphed. Quite impressive overall.
John Allen
John Allen August 02, 2024
Took a moment to build, but the payoff was spectacular. The middle had a deliberate pace, but the climax was phenomenal. A wonderful companion for a quiet weekend.
Barbara  Davis
Barbara Davis January 20, 2024
Such a rich narrative. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. I am now a lifelong fan of this author.
Gary  Davis
Gary Davis July 04, 2024
Such a rich narrative. The prose is exquisite. It’s accessible yet undeniably sophisticated. Worth every moment spent reading.
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Mary Phillips
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Exceeded all my expectations. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. I will undoubtedly revisit this masterpiece.
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Honestly one of the most premium reading experiences lately. The author orchestrated a breathtaking finale. Truly a work of art. A true literary gem.
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Stephanie Lee June 11, 2025
Masterpiece from start to finish. The prose is exquisite. It’s accessible yet undeniably sophisticated. I will undoubtedly revisit this masterpiece.
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Christopher Hill
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John Clark
John Clark August 17, 2024
Absolutely brilliant. I became deeply invested in the protagonist's journey. A masterclass in storytelling. A true literary gem.
Elizabeth Young
Elizabeth Young February 17, 2024
A highly sophisticated read. It held my rapt attention, even when certain twists were telegraphed. A very distinguished novel.
Susan Garcia
Susan Garcia August 02, 2025
Took a moment to build, but the payoff was spectacular. A brilliant concept executed with flair. Just a few pacing choices I would change. A very distinguished novel.
Joseph Lee
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Masterpiece from start to finish. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. Worth every moment spent reading.
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Jennifer Johnson March 22, 2024
I was completely blown away. The prose is exquisite. It’s accessible yet undeniably sophisticated. Worth every moment spent reading.
Mary Green
Mary Green December 04, 2024
A highly sophisticated read. Beautiful writing, though I craved slightly more depth in the lore. Still, undeniably engaging. I would highly recommend this to discerning readers.
Robert White
Robert White March 23, 2025
Exceeded all my expectations. It strikes a perfect harmony of dialogue and world-building. Every chapter felt necessary. Worth every moment spent reading.
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A profoundly satisfying read. I adored how the story unfolded. It kept me captivated without sacrificing elegance. An absolute must-read for connoisseurs of the genre.
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Exceeded all my expectations. The prose is exquisite. It’s accessible yet undeniably sophisticated. Worth every moment spent reading.
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A profoundly satisfying read. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. An effortless 5 stars.
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Kevin King June 07, 2024
A highly sophisticated read. The middle had a deliberate pace, but the climax was phenomenal. A very distinguished novel.
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Melissa Collins November 24, 2025
Absolutely brilliant. The author orchestrated a breathtaking finale. Truly a work of art. Worth every moment spent reading.
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Lisa Taylor June 29, 2024
Absolutely brilliant. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. An absolute must-read for connoisseurs of the genre.
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Mark Gomez October 05, 2025
Absolutely brilliant. The author orchestrated a breathtaking finale. Truly a work of art. An absolute must-read for connoisseurs of the genre.
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Christopher Edwards May 07, 2025
Absolutely brilliant. The author orchestrated a breathtaking finale. Truly a work of art. A true literary gem.
Gary Clark
Gary Clark April 03, 2024
Absolutely brilliant. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. An effortless 5 stars.
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Deborah Parker June 20, 2025
Took a moment to build, but the payoff was spectacular. The middle had a deliberate pace, but the climax was phenomenal. I would highly recommend this to discerning readers.
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Masterpiece from start to finish. The author orchestrated a breathtaking finale. Truly a work of art. I am now a lifelong fan of this author.
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A profoundly satisfying read. I adored how the story unfolded. It kept me captivated without sacrificing elegance. A true literary gem.
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Jennifer Edwards February 02, 2025
Honestly one of the most premium reading experiences lately. I became deeply invested in the protagonist's journey. A masterclass in storytelling. A true literary gem.
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A profoundly satisfying read. I became deeply invested in the protagonist's journey. A masterclass in storytelling. Worth every moment spent reading.
Rebecca Wilson
Rebecca Wilson March 23, 2024
A decent, if standard, experience. The tempo was somewhat languid, and I found my mind wandering. Not poor, simply average. Perfectly average.
Sandra Turner
Sandra Turner November 16, 2025
A very strong entry. The middle had a deliberate pace, but the climax was phenomenal. A very distinguished novel.
Jacob Lewis
Jacob Lewis March 14, 2025
Exceeded all my expectations. I became deeply invested in the protagonist's journey. A masterclass in storytelling. An absolute must-read for connoisseurs of the genre.
Kenneth Reyes
Kenneth Reyes October 06, 2024
A very strong entry. The middle had a deliberate pace, but the climax was phenomenal. I would highly recommend this to discerning readers.
Carol Lee
Carol Lee May 26, 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.
Andrew Anderson
Andrew Anderson March 07, 2025
I was completely blown away. The prose is exquisite. It’s accessible yet undeniably sophisticated. An absolute must-read for connoisseurs of the genre.
Christopher Rivera
Christopher Rivera March 18, 2025
A profoundly satisfying read. I adored how the story unfolded. It kept me captivated without sacrificing elegance. I am now a lifelong fan of this author.
Michael Adams
Michael Adams October 23, 2025
Honestly one of the most premium reading experiences lately. The pacing was impeccable and the characters felt incredibly authentic. I was completely immersed. An absolute must-read for connoisseurs of the genre.
Charles Green
Charles Green November 21, 2025
Such a rich narrative. The author orchestrated a breathtaking finale. Truly a work of art. Worth every moment spent reading.
Joseph Williams
Joseph Williams February 11, 2024
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.
Kenneth Evans
Kenneth Evans July 30, 2024
A profoundly satisfying read. I adored how the story unfolded. It kept me captivated without sacrificing elegance. Worth every moment spent reading.
Kevin King
Kevin King April 25, 2025
A very strong entry. It held my rapt attention, even when certain twists were telegraphed. Quite impressive overall.
Lisa Clark
Lisa Clark April 12, 2024
An acceptable diversion. Certain acts were fascinating, while others felt like a slight endeavor to complete. Suitable if your reading queue is empty.
Betty Mitchell
Betty Mitchell April 27, 2025
Such a rich narrative. The prose is exquisite. It’s accessible yet undeniably sophisticated. An effortless 5 stars.
Kevin King
Kevin King February 24, 2025
A highly sophisticated read. The middle had a deliberate pace, but the climax was phenomenal. A wonderful companion for a quiet weekend.
Jacob Lewis
Jacob Lewis July 20, 2024
Absolutely brilliant. I adored how the story unfolded. It kept me captivated without sacrificing elegance. Worth every moment spent reading.
Sarah Evans
Sarah Evans December 14, 2024
A decent, if standard, experience. Certain acts were fascinating, while others felt like a slight endeavor to complete. Suitable if your reading queue is empty.
Melissa Walker
Melissa Walker July 25, 2024
A highly sophisticated read. The middle had a deliberate pace, but the climax was phenomenal. A solid 4 stars from me.
Jacob Allen
Jacob Allen January 28, 2025
Absolutely brilliant. I adored how the story unfolded. It kept me captivated without sacrificing elegance. Worth every moment spent reading.
George Anderson
George Anderson May 06, 2025
I was completely blown away. I became deeply invested in the protagonist's journey. A masterclass in storytelling. An effortless 5 stars.
Emily Edwards
Emily Edwards July 26, 2024
A profoundly satisfying read. I became deeply invested in the protagonist's journey. A masterclass in storytelling. An effortless 5 stars.
Elizabeth Clark
Elizabeth Clark September 24, 2024
Excellent, though slightly flawed. A brilliant concept executed with flair. Just a few pacing choices I would change. A wonderful companion for a quiet weekend.
Daniel Smith
Daniel Smith October 15, 2024
I find myself somewhat conflicted. It possessed moments of brilliance, but the narrative felt slightly disjointed ultimately. Suitable if your reading queue is empty.
William Turner
William Turner November 28, 2025
Excellent, though slightly flawed. The protagonist was compelling, though some subplots felt slightly overshadowed. A wonderful companion for a quiet weekend.
Carol Gonzalez
Carol Gonzalez September 17, 2024
A highly sophisticated read. The protagonist was compelling, though some subplots felt slightly overshadowed. A wonderful companion for a quiet weekend.
Joshua Flores
Joshua Flores January 22, 2025
Masterpiece from start to finish. The prose is exquisite. It’s accessible yet undeniably sophisticated. A true literary gem.
Kenneth Wright
Kenneth Wright January 07, 2024
A highly sophisticated read. The protagonist was compelling, though some subplots felt slightly overshadowed. I would highly recommend this to discerning readers.
Cynthia Gomez
Cynthia Gomez January 19, 2024
Absolutely brilliant. The prose is exquisite. It’s accessible yet undeniably sophisticated. An effortless 5 stars.
Daniel Garcia
Daniel Garcia October 07, 2024
Honestly one of the most premium reading experiences lately. The author orchestrated a breathtaking finale. Truly a work of art. An effortless 5 stars.
Susan Martin
Susan Martin August 23, 2024
Honestly one of the most premium reading experiences lately. The prose is exquisite. It’s accessible yet undeniably sophisticated. A true literary gem.
Mark Gomez
Mark Gomez December 13, 2025
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.
James Martin
James Martin January 08, 2024
It was adequate. It verged on repetitive in the second act. A more concise edit would have served it well. Unlikely to reread, but a reasonable expenditure of time.
Stephanie Garcia
Stephanie Garcia October 07, 2024
Absolutely brilliant. The author orchestrated a breathtaking finale. Truly a work of art. A true literary gem.
Dorothy Thomas
Dorothy Thomas April 27, 2024
Honestly one of the most premium reading experiences lately. The prose is exquisite. It’s accessible yet undeniably sophisticated. A true literary gem.
David Williams
David Williams June 24, 2024
Masterpiece from start to finish. The author orchestrated a breathtaking finale. Truly a work of art. An effortless 5 stars.
Nicholas Gonzalez
Nicholas Gonzalez October 27, 2024
Absolutely brilliant. I adored how the story unfolded. It kept me captivated without sacrificing elegance. I am now a lifelong fan of this author.
Barbara Lewis
Barbara Lewis January 07, 2025
A profoundly satisfying read. The prose is exquisite. It’s accessible yet undeniably sophisticated. I will undoubtedly revisit this masterpiece.
Cynthia Gomez
Cynthia Gomez June 22, 2025
Such a rich narrative. The prose is exquisite. It’s accessible yet undeniably sophisticated. Worth every moment spent reading.
Carol Lee
Carol Lee January 24, 2025
Honestly one of the most premium reading experiences lately. The prose is exquisite. It’s accessible yet undeniably sophisticated. I will undoubtedly revisit this masterpiece.
Mark Jackson
Mark Jackson May 04, 2024
Absolutely brilliant. I became deeply invested in the protagonist's journey. A masterclass in storytelling. Worth every moment spent reading.
Cynthia  Davis
Cynthia Davis February 03, 2024
Absolutely brilliant. I adored how the story unfolded. It kept me captivated without sacrificing elegance. An absolute must-read for connoisseurs of the genre.
William Turner
William Turner October 01, 2024
I was completely blown away. 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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