Forefoot / Midfoot · Trauma · Infection & Wound · Standard
Night Page
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
"I got shot in my foot."
21-year-old male, paged by the ED in the early morning hours for a right foot gunshot wound.
History of present illness
Shot in the right foot about 2 hours ago with an unknown weapon type.
- Last meal 1 hour ago (not NPO)
- Tetanus immunization 3 years ago
- Able to move the toes; pain across the whole foot
- Numbness along the adjacent sides of the 3rd and 4th toes
- No other injuries identified by the ED trauma survey
- Bleeding controlled with a dressing in the ED
Questions a strong candidate asks at this step
- Mechanism, weapon (handgun vs. rifle vs. shotgun), range, entry and exit wounds
- Time since injury (open fractures: antibiotics early, OR within about 24 hours)
- NPO status (ate 1 hour ago)
- Tetanus status
- Other injuries; ED primary and secondary survey complete
- Pain, numbness, color/temperature change (6 Ps)
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.