Forefoot / Midfoot · Diabetic Limb & Charcot · Infection & Wound · Standard
Discharge Antibiotics?
Podiatric surgery residency interview case. Work through it the way you would at an interview: take the history, ask for the exam and imaging, then commit to a diagnosis and plan.
Chief complaint
"Can you recommend discharge antibiotics?"
The internal medicine resident pages you about a diabetic patient with a foot wound admitted yesterday. WBC 11,800; temperature 37.9 °C.
History of present illness
Adult diabetic patient admitted yesterday for a left foot wound. Medicine started empiric IV antibiotics and wants recommendations so the patient can go home.
- Wound present for several months, enlarging over the past 2 weeks with foul-smelling drainage
- Prior partial amputation of toes on this foot
- Low-grade fevers at home; no chills or rigors
- Blood glucose running 250–350 mg/dL since admission
- Neuropathic — reports little pain
Questions a strong candidate asks at this step
- Duration of the wound and recent change (size, drainage, odor, color)
- Prior wounds and amputations; how they healed
- Constitutional symptoms; glucose control
- What antibiotics have been given and for how long
- Pain (often absent with neuropathy)
Present the rest of the case
Past history, exam, imaging, assessment, plan and discussion questions, with model answers, are in the interactive trainer. The diagnosis is kept there on purpose so you can practice committing to one.