This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Management (Carcinoma Cervix), Subject name: Gynaecology & Obstetrics
A 45 year old lady complains contact bleeding. She has positive pap smear. The next line of management is - 
Select and explain. 
A. Colposcopy directed bioipsy, B. Cone biopsy, C. Repeat papsmear, D. Hysterectomy
A: Colposcopy directed bioipsy
Answer: A: Colposcopy directed bioipsy 
Explanation: Ans. is 'a' Colposcopy directed biopsy (Ref. Shaws, 7 3/e, p 384 (12/e, p289)).Pap smear is a screening procedure for carcinoma cervix.Positive pap smear means that cytology as abnormal. Now it needs to be confirmed by biopsy. Colposcopy will help in accurate localization of the abnormal tissue and helps in reducing false negative findings.Indications of colposcopy :Abnormal cytologyFor diagnosis of suspicious invasive lesion.Diagnostic directed biopsy.Conservative therapy under colposcopic guidance.Follow-up of cases treated conservatively.