A 35 year old female presented with post coital bleeding. Next step of management is:: (A) Pap smear and colposcopy, (B) Visual inspection with acetowhite, (C) Visual inspection with lugol's iodine, (D) Colposcopy directed biopsy
Answer is A. Postcoital bleeding (PCB) has many causes, including vaginitis, cervicitis, cervical dysplasia and malignancy, uterine lesions, and pregnancy. Some women with postcoital bleeding may have pathologic lesions identified at colposcopic evaluation that had been missed by Pap smear screening. Thus, colposcopic examination is considered for women with unexplained postcoital bleeding. Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 8. Abnormal Uterine Bleeding. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e.