NMS Q&A Family Medicine

106 NMS Q&A Family Medicinehemochromatosis, but patients with that disease do notbecome symptomatic until late middle age for men andlater still for women.16. The answer is E. Hepatitis A is transmitted mainly byfecal–oral contamination; it generally risks no complications.17. The answer is A. Hepatitis B is transmitted by bodyfluids other than gastrointestinal; it carries high risk ofchronic hepatitis and sexual transmission.18. The answer is D. Hepatitis C is transmitted by bodyfluids other than gastrointestinal; it carries a very highrisk of chronic hepatitis; it is prominent in transfusioninducedhepatitis, but there is less risk of sexual and accidentalneedle-stick transmission (4% chance). Approximately50% of cases progress to chronic hepatitis.19. The answer is C. Hepatitis D may be transmitted bypercutaneous or nonpercutaneous means; it requirespresence of hepatitis B to procreate.20. The answer is B. Hepatitis E is transmitted mainly byfecal–oral contamination; it is fraught with no complicationsexcept in third-trimester pregnancy.ReferencesGiboney PT . Mildly elevated liver transaminase levels in the asymptomaticpatient . Am Fam Physician . 2005 ; 71 : 1105 – 1110 .Lin KW , Kirchner JT . Hepatitis B . Am Fam Physician. 2004 ; 69 :75 – 82 , 86.McPhee SJ , Papadakis MA . Current Medical Diagnosis and Treatment2010 , 49th ed. New York /Chicago: McGraw-Hill; 2010.Nidiry JJ . Diseases of the liver . In: Rudy DR , Kurowski K , eds.Family Medicine: House Officer Series . Baltimore : Williams &Wilkins ; 1997 : 255 – 268 .