Question

A 65-year-old man with long-standing type 2 diabetes and peripheral vascular disease presents with a plantar ulcer under the first metatarsal head. The ulcer is deep with surrounding callus but minimal erythema. Peripheral pulses are weak. What is the MOST important initial step in management?

Accepted Answer

Refer for urgent vascular assessment and multidisciplinary diabetic foot clinic review

Answer

Start empirical oral antibiotics for all ulcers

Answer

Advise bed rest and observation

Answer

Apply topical antiseptic only

Answer

Prescribe high-dose systemic corticosteroids

Practice question

A 65-year-old man with long-standing type 2 diabetes and peripheral vascular disease presents with a plantar ulcer under the first metatarsal head. The ulcer is deep with surrounding callus but minimal erythema. Peripheral pulses are weak. What is the MOST important initial step in management?