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A 38-year-old woman presents with painless post-coital bleeding. She had a cone biopsy for carcinoma in situ five years ago. Her last smear was three months ago, following this. Her last period was six weeks ago.Mostproable diagnosis is:

A
Carcinoma of cervix
B
Ectopic pregnancy
C
Endometrial carcinoma.
D
Uterine fibroids.
High-Yield Explanation
The recurrence of abnormal vaginal bleeding in a patient with a previous history of a cone biopsy would raise concerns of carcinoma of the cervix. Her last smear was nearly five years ago,indicating she defaulted from follow-up after her cone biopsy. Six weeks amenorrhoeamight raise concerns about an ectopic pregnancy but the absence of pain makes this unlikely. It would always be wise to perform a pregnancy test and scan if in any about.

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