This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Gynaecology & Obstetrics
. Pap smear of Lelawati 45 years female shows CIN grade III. Which of the following is the next step in management: 
Select and explain. 
A. Punch biopsy, B. Large loop excision, C. Colposcopy directed biopsy, D. Cone biopsy
C: Colposcopy directed biopsy
Answer: C: Colposcopy directed biopsy 
Explanation: • 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.