You have a patient who is very health-conscious and regularly ingests a large number of vitamins in megadoses and herbal therapies on a daily basis. She is a strict vegetarian as well. She is going to attempt pregnancy and wants your advice regarding her diet and nutrition intake. Which of the following is true regarding diet recommendations in pregnancy?
a. Because herbal medications are natural, there is no reason to avoid these dietary supplements in pregnancy
b. It is recommended that in pregnancy the majority of the protein consumed be supplied from animal sources
c. Routine supplementation of vitamin A is necessary during pregnancy because dietary intake alone does not provide sufficient amounts needed during pregnancy
d. During pregnancy, vegetarians obtain sufficient amounts of vitamin B12 in their diet needed for the fetus
e. Vitamin C supplementation in pregnancy is to be avoided because excessive levels can result in fetal malformations
the answer is below…
The United States Medical Licensing Examination, or USMLE for short, is a three-part licensing examination that is required in order to receive a license to practice medicine within the United States.
The USMLE assesses a physician’s ability to apply knowledge, concepts, and principles, and to determine fundamental patient-centered skills that are important in health and disease and that constitute the basis of safe and effective patient care.Examination committees composed of medical educators and clinicians from across the United States and its territories prepare the examination materials each year.
This exam is designed by the Federation of State Medical Boards and the National Board of Medical Examiners to determine whether or not an individual understands and can apply the knowledge necessary to practice medicine safely and intelligently.
The USMLE is actually comprised of three different exams that are referred to as steps, which examine the individual’s knowledge of specific topics related to the field of medicine such as basic science, medical knowledge, medical skills, clinical science, and the application of all of these skills and areas of knowledge in the medical field.
All three steps of the USMLE include a series of computerized multiple-choice questions, but the format of the exam and the information covered in each multiple-choice section is different for each step of the USMLE. The USMLE Step II also has a clinical skills portion that examines an individual’s ability to work with real patients and the USMLE Step III has a computerized patient simulation portion in addition to the multiple-choice section of the exam. In order for an individual to receive a license to practice medicine, the individual must pass all three steps of the USMLE.
The correct answer is b; It is recommended that in pregnancy the majority of the protein consumed be supplied from animal sources.
The use of herbal remedies is not recommended during pregnancy because such products are classified as dietary supplements and therefore are not FDA-regulated for purity, safety, and efficacy. In fact, the actual ingredients of many herbal substances are not even known. There is almost no data regarding the teratogenic potential of herbal medications in humans. It is not recommended that women assume a vegetarian diet during pregnancy, because animal sources of protein such as meat, poultry, fish, and eggs contain amino acids in the most desirable combinations. In addition, strict vegetarians can give birth to infants who are low in vitamin B12 stores, because vitamin B12 occurs naturally only in foods of animal origin. Pregnant women do not need to take vitamin A supplements because adequate amounts can be obtained in the diet; in addition, a very high intake of vitamin A has been associated with the type of congenital malformations seen with oral Accutane use. Adequate vitamin C levels needed for pregnancy can be provided in a reasonable diet. No known fetal anomalies have been reported with vitamin C supplementation in pregnancy.