Ans. D. Obvious Visible growth. (Ref Textbook of Gynaecology by D C Dutta 5th/pg. 112 - 113)Shaw's Textbook of Gynaecology 14th/pg. 447 - 448.......... under the heading "Colposcopy'' and subheading "indications"........."Colposcopy is not needed routinely in all patients, or patients with obvious lesions.""INDICATIONS for colposcopy:# Diagnostic screening procedures are:- Abnormal Pap smear of cervix. Even CIN-I (especially those with positive HPV infection) should be screened, because as much as 50% of CIN-I have revealed CIN-II & -III on colposcopy and on susequent histology.- Abnormal areas on the vagina and preoperative assessment in early stages of cancer cervix.- Abnormal vulval area.- Locate the abnormal areas and biopsy.# Therapeutic Indications:- Precise conservative Rx with laser and cone biopsy can be performed in CIN lesions under colposcopic guidance using micromanipulator which delineates the area and destroys the entire lesion. Depth of destruction of 4-5 mm is adequate in CIN lesions. Depth of 1 cm may sometimes be required.- Lifelong follow-up of conservative Rx."Textbook of Gynaecology by D C Dutta 5th/pg. 112 - 113.......under the heading "Breast self examination"......................:"The important selective groups to be examined by colposcopy are:1. Women with abnormal smears.2. Women with clinically suspicious cervices specially with history of contact bleeding despite the presence of negative smears.3. Where the lesion is not clinically detected, colposcopic directed biopsy offers maximum reliability.4. Conservative methods of Rx of CIN can be effectively performed colposcopically as an OPD procedure."Also remember:# Colposcopy was first introduced by Hinselmann in 1927.# Colposcope is a binocular instrument providing a magnification of 10-20 times and colpomiscoscope 100-300 times.# In the technique of colposcopy, patient is placed in lithotomy, the cervix is exposed with a bivalve spectrum, and the colposcope focused on the external os at a distance of about 20 cm.# Coloposcopic findings are graded according to degree of acetowhite lesion, surface contour, mosiac pattern and punctuation as well as atypical vessesls.# Colposcopy should be preferably restricted to first trimester pregnancy, as it can cause bleeding, besides causing discomfort.# Because of multifocal lesions, wide vaginal angle, colposcopic examination of the vagina is difficult.# Colposcopy of the vagina is indicated in the following conditions:- To evaluate vagina with abnormal Pap smear but normal colopscopic findings of cervix.- Rule out extension of CIN.- Women with HPV infection.- Gross lesion present.- Follow-up of hysterectomy or conservative therapy performed for CIN disease.# Colposcopy of the vulva is not always informative due to keratinization and deep seated vessels.