Forefoot / Midfoot · Infection & Wound · Vascular · Advanced
Toe Wound
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
"My toe turned dark and it smells."
64-year-old male; ED consult for a gangrenous left 4th toe.
History of present illness
Came to the ED after a minor motor vehicle accident and was found to have a dark, foul-smelling left 4th toe. He is unsure how long it has been there because he cannot feel his feet.
- Drainage from a wound at the 4th toe
- Mild chills; no chest pain or SOB
- No pain in the foot
Questions a strong candidate asks at this step
- Duration, how it started (trauma, shoe, ingrown nail), progression
- Drainage, odor, spreading redness
- Constitutional symptoms
- Rest pain, claudication
- Dialysis schedule and last session
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.