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Diabetic foot ulcer — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareDiabetic foot ulcerUSMLE Step 3

A 64-year-old man with diabetes has a plantar ulcer under the first metatarsal head. It is 1 cm, clean-based, and probes to soft tissue but not bone. He has reduced monofilament sensation and palpable pulses. He has no fever or erythema. Which of the following is the most appropriate next step in management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Offload pressure and arrange wound care

Uninfected neuropathic foot ulcers require pressure offloading, local wound care, and assessment for vascular disease rather than antibiotics.

Reference: IWGDF/IDSA Diabetic Foot Infection Guideline