Cancer: visual inspection with acetic acid: practice question

A PSM question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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PSM · Cancer: visual inspection with acetic acid

Sample item

At a screening camp a trained nurse applies 5 percent acetic acid to the cervix of a 42-year-old woman and sees a well-defined dense acetowhite area adjacent to the squamocolumnar junction. What is the next step?

AStart radiotherapyBTreat as vaginal candidiasisCRefer for colposcopy and directed biopsyDReport as normal and repeat after 5 years

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Refer for colposcopy and directed biopsy

Visual inspection with acetic acid is positive when a distinct acetowhite area appears near the squamocolumnar junction, and indicates possible cervical precancer. The woman needs confirmation by colposcopy and biopsy so that treatment such as cryotherapy or LEEP can follow. A negative test is repeated at the screening interval of about 5 years.

Option by option

A. Start radiotherapy
Radiotherapy is for invasive cancer proven by biopsy, and none has been proved.
B. Treat as vaginal candidiasis
Candidiasis presents with curdy discharge and plaques, whereas a dense well-defined acetowhite area near the squamocolumnar junction is the positive VIA pattern.
C. Refer for colposcopy and directed biopsy (correct)
Correct. A positive test needs confirmation of the lesion before treatment is planned.
D. Report as normal and repeat after 5 years
The 5-year repeat applies only to a negative result.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this PSM question

What is the answer to this PSM question?

The best answer is C, Refer for colposcopy and directed biopsy. Visual inspection with acetic acid is positive when a distinct acetowhite area appears near the squamocolumnar junction, and indicates possible cervical precancer.

Why is "Start radiotherapy" not the answer?

Radiotherapy is for invasive cancer proven by biopsy, and none has been proved.

Why is "Treat as vaginal candidiasis" not the answer?

Candidiasis presents with curdy discharge and plaques, whereas a dense well-defined acetowhite area near the squamocolumnar junction is the positive VIA pattern.

Why is "Report as normal and repeat after 5 years" not the answer?

The 5-year repeat applies only to a negative result.

What concept does this question test?

It tests Cancer: visual inspection with acetic acid in PSM. The woman needs confirmation by colposcopy and biopsy so that treatment such as cryotherapy or LEEP can follow. A negative test is repeated at the screening interval of about 5 years.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cancer: visual inspection with acetic acid?

Practise biostatistics with small calculations until sensitivity, predictive values and risk measures are automatic. Then use the flashcards and the other PSM questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.