<prompt> The Investigation of choice in a 55-year-old postmenopausal women who has presented with postmenopausal bleeding is:Pap smearFractional curettageTransvaginal ultrasoundCA-125 estimation  <response>: Common causes of postmenopausal bleeding Genital malignancy Me Decubitus ulcer DUB. Urethral caruncle. Senile endometritis DIAGNOSIS Speculum Examination If a growth is found, punch biopsy is to be taken. If no growth is visible and the cervix looks apparently healthy- Cervical smear Aspiration cytology Fractional curettage, if the cervical cytology becomes negative. Hysteroscopic evaluation and directed biopsy Laparoscopy in suspected cases of ovarian or adnexal mass. Detection of a benign lesion should not prevent fuher detailed investigations to rule out malignancy. 