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
Investigation of choice in postcoital bleeding in a 60-year-old lady is: 
Select and explain. 
A. Pap smear, B. Colposcopy and biopsy, C. Pelvic ultrasound, D. Cone excision of cervix
B: Colposcopy and biopsy
Answer: B: Colposcopy and biopsy 
Explanation: An old lady presenting to OPD with post coital bleeding with a leison visible on cervix- raises the suspium carcinoma cervix in this case because CIN is asyntomatic . In such cases pap smear is of no use and directly biopsy should be done. Since lesion is visible we will go for punch biopsy.
Investigation Protocol for Diagnosis of Carcinoma Cervix: