Which combination represents the 4Fs risk factors for liver disorders?

• A. Forty, Female, Fat, Fertile
• B. Fifty, Female, Fat, Fertile
• C. Thirty, Male, Lean, Sterile
• D. Sixty, Female, Muscle, Fertile

Answer: (A)

The 4Fs refer to risk factors for cholesterol gallstones: Female, Fat, Forty, Fertile. This combination—around age 40, being female, having obesity, and being in a reproductive phase—tavors supersaturation of cholesterol in bile and can slow gallbladder emptying, promoting stone formation. Therefore Forty, Female, Fat, Fertile matches the 4Fs best. The other options mix in male sex, lean body habitus, sterility, or non-reproductive status, which do not fit the 4Fs.