<prompt> A high grade squamous intraepithelial lesion is noted with pap, next management includes -Wahims hysterectomyLocal excisionColposcolic study and biopsyHPV DNA testing  <response>: Ans isci.e., Colposcolic study and biopsyFor high grade intraepithelial lesions HSIL, first step is to do colposcopy and biopsy. Moderate to severe dysplasiaCIN-II CIN-III HSIL:Treatment options are:Local destructive methodsCryosurgeryFulgurationelectrocoagulation .Laser ablationExcision of abnormal tissueCold knife conisationLaser conisationLLETZLEEPNETZSurgery:Therapeutic conisationHysterectomyHysterectomy with removal of vaginal cuff if carcinoma in situ extends into vaginal vault 