Endocrinology: diabetic foot: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Endocrinology: diabetic foot

Sample item

A diabetic man has a painless punched-out ulcer on the plantar surface under the first metatarsal head with warm foot and bounding pulses. What is the ulcer type and key management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Neuropathic ulcer; offloading, debridement and infection control

Neuropathic ulcers occur at pressure points such as the metatarsal heads, are painless and the foot is warm with intact pulses. Offloading, debridement, appropriate footwear and treatment of infection are central. Ischaemic ulcers are painful, at the toes and edges, with absent pulses.

Option by option

  • A. Venous ulcer; compression

    Venous ulcers occur near the medial malleolus.

  • B. Ischaemic ulcer; angioplasty only

    Ischaemic ulcers are painful with absent pulses.

  • C. Neuropathic ulcer; offloading, debridement and infection control (correct)

    Correct. Painless plantar ulcer with good pulses is neuropathic.

  • D. Arterial ulcer; amputation

    Amputation is not first-line for an uncomplicated neuropathic ulcer.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Neuropathic ulcer; offloading, debridement and infection control. Neuropathic ulcers occur at pressure points such as the metatarsal heads, are painless and the foot is warm with intact pulses.

Why is "Venous ulcer; compression" not the answer?

Venous ulcers occur near the medial malleolus.

Why is "Ischaemic ulcer; angioplasty only" not the answer?

Ischaemic ulcers are painful with absent pulses.

Why is "Arterial ulcer; amputation" not the answer?

Amputation is not first-line for an uncomplicated neuropathic ulcer.

What concept does this question test?

It tests Endocrinology: diabetic foot in General Medicine. Offloading, debridement, appropriate footwear and treatment of infection are central. Ischaemic ulcers are painful, at the toes and edges, with absent pulses.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Endocrinology: diabetic foot?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.