This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Cervical Carcinoma, Subject name: Gynaecology & Obstetrics
A 55 year old lady presenting to OPD with postmenopausal bleeding for 3 months has a 1 x1cm nodule on the anterior lip of cervix, The most appropriate investigation to be done subsequently is 
Select and explain. 
A. Pap smear, B. Punch biopsy, C. Endocervical currettage, D. Colposcopy & biopsy
B: Punch biopsy
Answer: B: Punch biopsy 
Explanation: Post menopausal bleeding with a visible cervical growth needs a tissue diagnosis, done by a punch biopsy of the lesion. Paps smear is a screening test, done in asymptomatic patients. Colposcopy + biopsy is a diagnostic test, indicated in symptomatic patients, like those with postmenopausal or post coital bleeding, or in asymptomatic patients where paps screening was done and turned out abnormal Endocervical curettage is indicated in patients with suspected endocervical lesion, or if entire transformation zone could not be evaluated at colposcopy