<prompt> Young female, multigravida presenting with post coital bleeding, vagina - normal, cervix - hyperophied, Next step?Pap smearColposcopy biopsyCryotherapyPVaginal examination  <response>: Post coital bleeding is the - most common presentation of CA cervix PAP smear is done when a patient is asymptomatic or sexually active women Here, The patient is symptomatic hence a confirmatory test is warranted to make a diagnosis. Doing a four Quadrant biopsy may help, but it is more of a Hit and trial kind of method since invasion could be staing in a different place away from the 4 biopsies sites. Performing a Colposcopic is the best procedure here than a Pap smear or the 4 Quad biopsy. If diagnosis is not confirmed even with a Colposcopic biopsy then the next step here is Conization of cervix . 