EconomyEnglish6.5/10 · BronzeCSV file availableUpdated 29 Sept 2026

ICMR Standard Treatment Workflow: Approach to Hyponatremia - Question and Answer Dataset

Name: ICMR Standard Treatment Workflow: Approach to Hyponatremia - Question and Answer Dataset
Creator: icmr.gov.in
Keywords: Economy, questionanswering, extractiveqa, general, icmr, standard, treatment, workflow, approach, hyponatremia, question, answer, dataset

#questionanswering#extractiveqa#general#icmr#standard#treatment#workflow#approach#hyponatremia#question#answer#dataset

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About this dataset

15 extractive question-and-answer pairs built from ICMR Standard Treatment Workflow (STW) APPROACH TO HYPONATREMIA, published by icmr.gov.in. Every answer is a verbatim span of text the source prints, and each row carries the passage it sits in, its offset in that passage, the source quote, the page and the location in the document, so any row can be checked against the original. 11 of the 15 pairs (73.3%) are explanatory questions and 4 restate a figure. 100.00% of rows pass the corpus quality gate.

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First 10 of 15 rows

Sample rows from ICMR Standard Treatment Workflow: Approach to Hyponatremia - Question and Answer Dataset
question	answer	context	answer_start	question_type	knowledge_quality_score	source_quote	source_page	source_location	confidence	validation_status
Why is rapid correction of sodium not advisable?	it may lead to central pontine myelinosis	Urgent intervention unnecessary Assess ECF volume and restrict fluid intake to 500-1000 ml/ 24 hour Likely Chronic Headache, irritability, difficulty in concentration, altered mood, depression Vomiting, seizures, obtundation, coma, respiratory distress, unstable gait/ falls Na deficit = .6x body weight (target Plasma Na-starting Na concentration) 1 litre of 3% hypertonic saline=513mM Na (1ml/kg/ hr increases serum Na by 1mM/hr) 1 litre of isotonic saline= 154 mM Na *Rapid correction of sodium is not advisable as it may lead to central pontine myelinosis Significant sequelae unlikely Assess ECF Volume status Yes Yes No No Is Hyponatremia severe? (<125 mmol/L)	518	relationship	0.970	Urgent intervention unnecessary Assess ECF volume and restrict fluid intake to 500-1000 ml/ 24 hour Likely Chronic Headache, irritability, difficulty in concentration, altered mood, depression Vomiting, seizures, obtundation, coma, respiratory distress, unstable gait/ falls Na deficit = .6x body weight (target Plasma Na-starting Na concentration) 1 litre of 3% hypertonic saline=513mM Na (1ml/kg/ hr increases serum Na by 1mM/hr) 1 litre of isotonic saline= 154 mM Na *Rapid correction of sodium is not advisable as it may lead to central pontine myelinosis Significant sequelae unlikely Assess	1	page=1,block=20	0.700	valid
What is the treatment for acute severe hyponatremia lasting less than 48 hours?	Emergency correction with hypertonic 3% saline 1-2 ml/kg/hr until safe Na target to a total 4-6m/M	Severe hyponatremia treatment Acute < 48 hours Emergency correction with hypertonic 3% saline 1-2 ml/kg/hr until safe Na target to a total 4-6m/M, this modest increase is sufficient to alleviate severe symptoms. After that corrective guidelines chronic hyponatremia are appropriate Chronic/Unknown ( > 48 hours ) Correction with 3% saline@ 0.5-1ml/kg/hour till resolution of symptoms or until safe Na target Correction* not > 8-10 mM within first 24 hours Oral Tolvaptan 15 mg on day one and then 30-60 mg per day if serum Na remains below 135 or rise is less than 5 mmol per 24 hours. 6 -8 hourly monitoring of serum Na to be done Duration?	47	summary	0.970	Severe hyponatremia treatment Acute < 48 hours Emergency correction with hypertonic 3% saline 1-2 ml/kg/hr until safe Na target to a total 4-6m/M, this modest increase is sufficient to alleviate severe symptoms.	1	page=1,block=20	0.700	valid
What are the characteristics of hypervolemia?	Total body water • Total body sodium	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total body water • Total body sodium Assessment of Volume status	409	summary	0.930	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total
What are some symptoms that indicate likely chronic hyponatremia?	Headache, irritability, difficulty in concentration, altered mood, depression	Urgent intervention unnecessary Assess ECF volume and restrict fluid intake to 500-1000 ml/ 24 hour Likely Chronic Headache, irritability, difficulty in concentration, altered mood, depression Vomiting, seizures, obtundation, coma, respiratory distress, unstable gait/ falls Na deficit = .6x body weight (target Plasma Na-starting Na concentration) 1 litre of 3% hypertonic saline=513mM Na (1ml/kg/ hr increases serum Na by 1mM/hr) 1 litre of isotonic saline= 154 mM Na *Rapid correction of sodium is not advisable as it may lead to central pontine myelinosis Significant sequelae unlikely Assess ECF Volume status Yes Yes No No Is Hyponatremia severe? (<125 mmol/L)	115	list	0.820	Urgent intervention unnecessary Assess ECF volume and restrict fluid intake to 500-1000 ml/ 24 hour Likely Chronic Headache, irritability, difficulty in concentration, altered mood, depression Vomiting, seizures, obtundation, coma, respiratory distress, unstable gait/ falls Na deficit = .6x body weight (target Plasma Na-starting Na concentration) 1 litre of 3% hypertonic saline=513mM Na (1ml/kg/ hr increases serum Na by 1mM/hr) 1 litre of isotonic saline= 154 mM Na *Rapid correction of sodium is not advisable as it may lead to central pontine myelinosis Significant sequelae unlikely Assess
What are some conditions associated with extrarenal fluid losses?	Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total body water • Total body sodium Assessment of Volume status	303	list	0.820	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total
What are the conditions associated with euvolemia without edema?	Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total body water • Total body sodium Assessment of Volume status	508	list	0.820	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total
What are the components assessed in volume status evaluation?	Total body water • Total body sodium	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total body water • Total body sodium Assessment of Volume status	409	list	0.820	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total
What are some symptoms associated with chronic hyponatremia?	Headache, irritability, difficulty in concentration, altered mood, depression	Urgent intervention unnecessary Assess ECF volume and restrict fluid intake to 500-1000 ml/ 24 hour Likely Chronic Headache, irritability, difficulty in concentration, altered mood, depression Vomiting, seizures, obtundation, coma, respiratory distress, unstable gait/ falls Na deficit = .6x body weight (target Plasma Na-starting Na concentration) 1 litre of 3% hypertonic saline=513mM Na (1ml/kg/ hr increases serum Na by 1mM/hr) 1 litre of isotonic saline= 154 mM Na *Rapid correction of sodium is not advisable as it may lead to central pontine myelinosis Significant sequelae unlikely Assess ECF Volume status Yes Yes No No Is Hyponatremia severe? (<125 mmol/L)	115	list	0.820	Urgent intervention unnecessary Assess ECF volume and restrict fluid intake to 500-1000 ml/ 24 hour Likely Chronic Headache, irritability, difficulty in concentration, altered mood, depression Vomiting, seizures, obtundation, coma, respiratory distress, unstable gait/ falls Na deficit = .6x body weight (target Plasma Na-starting Na concentration) 1 litre of 3% hypertonic saline=513mM Na (1ml/kg/ hr increases serum Na by 1mM/hr) 1 litre of isotonic saline= 154 mM Na *Rapid correction of sodium is not advisable as it may lead to central pontine myelinosis Significant sequelae unlikely Assess
What conditions can cause extrarenal losses of fluids?	Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total body water • Total body sodium Assessment of Volume status	303	list	0.820	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total
What are some causes of extrarenal losses in hypovolemia?	Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total body water • Total body sodium Assessment of Volume status	303	list	0.820	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total

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Details

Category: Economy
Language: English
Format: CSV
Rows: 15
File size: 20.0 KB
Licence: Not specified
Source: icmr.gov.in
DesiData Scale™: 6.5 / 10 · Bronze
Verified downloads: 0

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First 10 of 15 rows

Sample rows from ICMR Standard Treatment Workflow: Approach to Hyponatremia - Question and Answer Dataset
question	answer	context	answer_start	question_type	knowledge_quality_score	source_quote	source_page	source_location	confidence	validation_status
Why is rapid correction of sodium not advisable?	it may lead to central pontine myelinosis	Urgent intervention unnecessary Assess ECF volume and restrict fluid intake to 500-1000 ml/ 24 hour Likely Chronic Headache, irritability, difficulty in concentration, altered mood, depression Vomiting, seizures, obtundation, coma, respiratory distress, unstable gait/ falls Na deficit = .6x body weight (target Plasma Na-starting Na concentration) 1 litre of 3% hypertonic saline=513mM Na (1ml/kg/ hr increases serum Na by 1mM/hr) 1 litre of isotonic saline= 154 mM Na *Rapid correction of sodium is not advisable as it may lead to central pontine myelinosis Significant sequelae unlikely Assess ECF Volume status Yes Yes No No Is Hyponatremia severe? (<125 mmol/L)	518	relationship	0.970	Urgent intervention unnecessary Assess ECF volume and restrict fluid intake to 500-1000 ml/ 24 hour Likely Chronic Headache, irritability, difficulty in concentration, altered mood, depression Vomiting, seizures, obtundation, coma, respiratory distress, unstable gait/ falls Na deficit = .6x body weight (target Plasma Na-starting Na concentration) 1 litre of 3% hypertonic saline=513mM Na (1ml/kg/ hr increases serum Na by 1mM/hr) 1 litre of isotonic saline= 154 mM Na *Rapid correction of sodium is not advisable as it may lead to central pontine myelinosis Significant sequelae unlikely Assess	1	page=1,block=20	0.700	valid
What is the treatment for acute severe hyponatremia lasting less than 48 hours?	Emergency correction with hypertonic 3% saline 1-2 ml/kg/hr until safe Na target to a total 4-6m/M	Severe hyponatremia treatment Acute < 48 hours Emergency correction with hypertonic 3% saline 1-2 ml/kg/hr until safe Na target to a total 4-6m/M, this modest increase is sufficient to alleviate severe symptoms. After that corrective guidelines chronic hyponatremia are appropriate Chronic/Unknown ( > 48 hours ) Correction with 3% saline@ 0.5-1ml/kg/hour till resolution of symptoms or until safe Na target Correction* not > 8-10 mM within first 24 hours Oral Tolvaptan 15 mg on day one and then 30-60 mg per day if serum Na remains below 135 or rise is less than 5 mmol per 24 hours. 6 -8 hourly monitoring of serum Na to be done Duration?	47	summary	0.970	Severe hyponatremia treatment Acute < 48 hours Emergency correction with hypertonic 3% saline 1-2 ml/kg/hr until safe Na target to a total 4-6m/M, this modest increase is sufficient to alleviate severe symptoms.	1	page=1,block=20	0.700	valid
What are the characteristics of hypervolemia?	Total body water • Total body sodium	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total body water • Total body sodium Assessment of Volume status	409	summary	0.930	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total
What are some symptoms that indicate likely chronic hyponatremia?	Headache, irritability, difficulty in concentration, altered mood, depression	Urgent intervention unnecessary Assess ECF volume and restrict fluid intake to 500-1000 ml/ 24 hour Likely Chronic Headache, irritability, difficulty in concentration, altered mood, depression Vomiting, seizures, obtundation, coma, respiratory distress, unstable gait/ falls Na deficit = .6x body weight (target Plasma Na-starting Na concentration) 1 litre of 3% hypertonic saline=513mM Na (1ml/kg/ hr increases serum Na by 1mM/hr) 1 litre of isotonic saline= 154 mM Na *Rapid correction of sodium is not advisable as it may lead to central pontine myelinosis Significant sequelae unlikely Assess ECF Volume status Yes Yes No No Is Hyponatremia severe? (<125 mmol/L)	115	list	0.820	Urgent intervention unnecessary Assess ECF volume and restrict fluid intake to 500-1000 ml/ 24 hour Likely Chronic Headache, irritability, difficulty in concentration, altered mood, depression Vomiting, seizures, obtundation, coma, respiratory distress, unstable gait/ falls Na deficit = .6x body weight (target Plasma Na-starting Na concentration) 1 litre of 3% hypertonic saline=513mM Na (1ml/kg/ hr increases serum Na by 1mM/hr) 1 litre of isotonic saline= 154 mM Na *Rapid correction of sodium is not advisable as it may lead to central pontine myelinosis Significant sequelae unlikely Assess
What are some conditions associated with extrarenal fluid losses?	Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total body water • Total body sodium Assessment of Volume status	303	list	0.820	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total
What are the conditions associated with euvolemia without edema?	Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total body water • Total body sodium Assessment of Volume status	508	list	0.820	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total
What are the components assessed in volume status evaluation?	Total body water • Total body sodium	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total body water • Total body sodium Assessment of Volume status	409	list	0.820	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total
What are some symptoms associated with chronic hyponatremia?	Headache, irritability, difficulty in concentration, altered mood, depression	Urgent intervention unnecessary Assess ECF volume and restrict fluid intake to 500-1000 ml/ 24 hour Likely Chronic Headache, irritability, difficulty in concentration, altered mood, depression Vomiting, seizures, obtundation, coma, respiratory distress, unstable gait/ falls Na deficit = .6x body weight (target Plasma Na-starting Na concentration) 1 litre of 3% hypertonic saline=513mM Na (1ml/kg/ hr increases serum Na by 1mM/hr) 1 litre of isotonic saline= 154 mM Na *Rapid correction of sodium is not advisable as it may lead to central pontine myelinosis Significant sequelae unlikely Assess ECF Volume status Yes Yes No No Is Hyponatremia severe? (<125 mmol/L)	115	list	0.820	Urgent intervention unnecessary Assess ECF volume and restrict fluid intake to 500-1000 ml/ 24 hour Likely Chronic Headache, irritability, difficulty in concentration, altered mood, depression Vomiting, seizures, obtundation, coma, respiratory distress, unstable gait/ falls Na deficit = .6x body weight (target Plasma Na-starting Na concentration) 1 litre of 3% hypertonic saline=513mM Na (1ml/kg/ hr increases serum Na by 1mM/hr) 1 litre of isotonic saline= 154 mM Na *Rapid correction of sodium is not advisable as it may lead to central pontine myelinosis Significant sequelae unlikely Assess
What conditions can cause extrarenal losses of fluids?	Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total body water • Total body sodium Assessment of Volume status	303	list	0.820	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total
What are some causes of extrarenal losses in hypovolemia?	Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total body water • Total body sodium Assessment of Volume status	303	list	0.820	Renal failure - Nephrotic syndrome - Cirrhosis - Cardiac failure Renal Losses - Diuretic excess - Mineralocorticoid deficiency - Salt losing deficiency - Bicarbonaturia with renal tubal acidosis and metabolic alkalosis - Ketonuria - Osmotic diuresis - Cerebral salt wasting syndrome Extrarenal Losses - Vomiting - Diarrhea - Third spacing of fluids • Burns • Pancreatitis • Trauma UNa>20 UNa<20 Hypovolemia • Total body water • Total body sodium Euvolemia (No edema) • Total body water • Total body sodium - Glucocorticoid deficiency - Hypothyroidism - Stress - Drugs - SIADH Hypervolemia • Total

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ICMR Standard Treatment Workflow: Approach to Hyponatremia - Question and Answer Dataset

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