Please assess the following case study pertaining to the citizenship and immigration processes.

Case #1

Janelle was born in Canada. While living outside Canada, Janelle gave birth to Angela. Angela's father is not a Canadian citizen.

Angela grew up, and gave birth to Edward, who was also born outside Canada. Edward's father is not a Canadian citizen. Angela also adopted a child outside Canada, Marian.

Angela, Edward, and Marian would like to move to Canada, and are seeking your advice regarding the immigration and citizenship processes.

Please answer the following questions:

1) Could Angela, Edward and Marian acquire Canadian citizenship through the direct route? Please explain.

2) Could Marian sponsor her biological parents once she becomes a permanent resident of Canada? Please explain your answer by referring to the appropriate sections of the IRPA and Regulations.

3) Are adopted children required to undergo a medical examination with an IRCC Designated Medical Officer/practitioner to be eligible for permanent residence? Please explain.

4) Are adopted children required to undergo a medical exam with an IRCC Designated Medical officer/practitioner to be eligible for Canadian citizenship through the direct route? Please explain .

Ensure that along with opinion cite relevant sections and subsections of the Citizenship Act, Citizenship Regulations, IRPA, IRPR, Operations Manuals and/or Jurisprudence.