A 33-year-old female presents for routine cervical cancer screening. Liquid-based cytology demonstrates high-grade squamous intraepithelial lesion (HSIL). What is the mandatory next step in clinical management?
Answer and explanation
Correct answer: A. Colposcopy with directed biopsies
- Step 1: HSIL on cytology indicates significant cervical precancerous changes (CIN 2/3) with high risk of invasion if left untreated.
- Step 2: Immediate colposcopic visualization of the transformation zone with acetic acid and Lugol's iodine application, along with directed biopsies, is mandatory.
Answer
Colposcopy with directed biopsies.
Why not the others: 'Repeat Pap smear in 12 months' dangerously delays treatment of high-grade precancerous lesions; 'Prescription of oral antibiotics for cervicitis' is ineffective against HPV-driven dysplastic lesions; 'Immediate total abdominal hysterectomy' is overly aggressive as excisional procedures (LEEP/cone) preserve fertility and are curative for CIN.
Practise more Obstetrics, Gynecology and Maternal-Fetal Medicine.
Free questions with an explanation for every one, and full timed National Health Regulatory Authority Licensure Examination (NHRA Bahrain) mock tests.
More Obstetrics, Gynecology and Maternal-Fetal Medicine questions
- A 28-year-old primigravida at 34 weeks gestation presents with a blood pressure of 165/110 mmHg, persistent severe frontal headache, visual…
- A 26-year-old female presents with 7 weeks of amenorrhea, severe acute right lower quadrant pelvic pain, and light vaginal bleeding. On phys…
- A 32-year-old gravida 3 para 2 at 32 weeks gestation presents with sudden, painless, bright red vaginal bleeding. She denies abdominal pain…
- A 36-year-old multigravida at 38 weeks gestation presents with sudden severe, continuous abdominal pain, dark vaginal bleeding, and high ute…
- Following an uncomplicated vaginal delivery of a 4.0 kg infant, a 28-year-old mother experiences heavy continuous vaginal bleeding. The plac…
- What is the first-line medication administered routinely for active management of the third stage of labor to prevent postpartum hemorrhage?