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Diabetic foot ulcer — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareDiabetic foot ulcerUSMLE Step 3

A 63-year-old man with diabetes has a plantar ulcer under the first metatarsal head. It is 1.5 cm, shallow, and surrounded by callus. There is no erythema, warmth, purulence, systemic symptom, or exposed bone. Monofilament sensation is absent. Pedal pulses are palpable. Which of the following is the most appropriate next step in management?

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

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Correct answer: A — Off-load pressure and arrange wound care with debridement

Neuropathic diabetic foot ulcers require off-loading, wound care, callus debridement, glycemic optimization, and infection assessment; antibiotics are reserved for infected wounds.

Reference: IWGDF/IDSA Diabetic Foot Infection Guideline