please answer the followim=ng quastions and send me your answer sheet 

:
Q1: A 22 year old farmer presents with a 10 month history of spontaneous hand
shaking. He is a little bit depressed since that time. He denied alcohol intake or
any illicit drug abuse. His cousin has a similar problem. Examination revealed a
coarse resting tremor with no intentional component, a dysarthric speech, and
down going planters.
His lab tests revealed:
Total serum bilirubin 1.5 mg/ dl
ALT 70 u/L
Alkaline phosphatase 90 u/L
What is your next investigation?
a. Serum ceruloplasmin.
b. 24 hours urinary calcium level.
c. Complete blood count.
d. CSF analysis.
e. Nerve conduction study.
Q2: An 18 year old male brought by his parents for assessing his general
conditions. His mother stated that her son's gait is awkward as if he is drunk and
progressively impaired since the age of 10 years, and he has difficulty in feeding
himself because his hands are too shaky and he seems to be deaf. Examination
revealed pes cavus, kyphoscoliosis, a wide based gait, impaired finger nose test,
absent ankle jerks and upgoing planters. What is your next step?
a. Doing an echocardiographic study.
b. Measuring serum TSH.
c. CSF opening pressure.
d. Blood film looking for acanthocytes.
e. Muscle biopsy looking for ragged red fibers.
Q3: A 50 year old woman with a history of breast cancer since 1 year which was
treated by lumpectomy and local radiotherapy at that time presents with
generalized headache that is partially responsive to analgesics since 2 months.
She is on no chemotherapy for the timebeing. Examination revealed
papilloedema, grade 4 minus pyramidal weakness in both lower limbs with
exaggerated reflexes and upgoing planters. Brain CT scan revealed a rounded
mass of 3 by 3 cm in the midline fissure with no surrounding edema that
enhanced diffusely after contrast administration.
Which one of the following steps would be unreasonable?
a. A brain MRI study with contrast.
b. Liver ultrasonographic study.
c. Bone isotop scan.
d. 24 hours urinary cortisol level.
e. 4-Vessel cerebral conventional angiography.