. Pap smear of Lelawati 45 years female shows CIN grade III. Which of the following is the next step in management:: (A) Punch biopsy, (B) Large loop excision, (C) Colposcopy directed biopsy, (D) Cone biopsy
Answer is C. • Pap smear is only a screening test. To confirm we need to do a biopsy.
• In all visible lesions punch biopsy should be done
• In case of invisible lesion colposcopic directed biopsy is the gold standard. Thus in this case since it is not mentioned growth is visible so we do colposcopy guided biopsy.