In this task, you are given a multiple-choice question about healthcare. Answer the question based on your information and classify your answers into '1', '2', '3', and '4'.

Question: Before a 49-year-old man, asymptomatic, with a family history of a father who died of prostate cancer, a PSA (Specific Prostate Antigen) of 5.9 ng / ml was identified in a routine company control, with a PSA ratio free / Total PSA of 11% and that in a digital rectal examination there is an increase in consistency in the right prostatic lobe, what is the following clinical indication? 
 Options:  <1> Ask the patient to perform a transrectal ultrasound and prostate biopsy. <2> Perform a abdominopelvic CT scan. <3> Start treatment with 5 alpha reductase inhibitors to halve PSA levels. <4> Start combined treatment of LHRH analogues and antiandrogens. <5> Perform a bone scan.
1

Question: Indicate which of the following deficits leads to a porphyria: 
 Options:  <1> Phenylalanine hydroxylase. <2> 21 α-hydroxylase. <3> Ferrochelatase <4> Glucokinase. <5> Tyrosine hydroxylase.
3

Question: The genetic phenomenon that explains that the expression of a gene is influenced by the sex of the parent is: 
 Options:  <1> Character limited by sex. <2> Characteristic linked to sex. <3> Cytoplasmic inheritance. <4> Genomic imprint <5> Maternal genetic effect.

4