<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 73-year-old man is brought in by his wife with a history of progressive personality changes. The patients wife says that, over the past 3 years, he has become increasingly aggressive and easily agitated, which is extremely out of character for him. His wife also says that he has had several episodes of urinary incontinence in the past month. He has no significant past medical history. The patient denies any history of smoking, alcohol use, or recreational drug use. The patient is afebrile, and his vital signs are within normal limits. A physical examination is unremarkable. The patient takes the mini-mental status examination MMSE and scores 2830. A T2 magnetic resonance image MRI of the head is performed and the results are shown in the exhibit see image. Which of the following is the next best diagnostic step in the management of this patient?? A: Noncontrast CT of the head, B: Contrast MRI of the head, C: Lumbar puncture, D: Brain biopsy, E: Serum ceruloplasmin level,  <response>: Based on the information provided in the question stem, this appears to be a case of a 73-year-old man presenting with progressive personality changes, aggression, agitation, and urinary incontinence over the past 3 years. The history, physical exam, and MMSE score of 2830 point towards a neurodegenerative process. The T2 MRI image shows bilateral symmetric hyperintensities in the medial temporal lobes, consistent with hippocampal atrophy. This clinical presentation and imaging findings are most consistent with Alzheimers disease. The next best diagnostic step would be to confirm this suspicion by obtaining a biomarker indicative of Alzheimers pathology. A lumbar puncture to analyze cerebrospinal fluid for amyloid-beta and tau proteins would be the most definitive next step. Brain biopsy would be too invasive. Noncontrast CT head would not provide additional useful information over the MRI. Contrast MRI may help delineate structural changes but would not provide specific biomarker evidence of Alzheimers disease. Checking serum ceruloplasmin level tests for Wilsons disease, which does not fit this clinical presentation.C: Lumbar puncture 