7 extractive question-and-answer pairs built from ICMR Standard Treatment Workflow (STW) APPROACH TO HYPONATREMIA, published by icmr.gov.in. The source is a 1-page publication. Source-evidenced topics include standard treatment workflow (stw), hyponatremia, icd-10-e87.1, renal failure, nephrotic syndrome, cirrhosis, cardiac failure, renal losses. 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. Question types in the export: 3 factual, 2 list, 1 relationship, 1 summary. 4 of the 7 pairs (57.1%) ask explanatory questions; the remaining 3 are factual or table-based questions. 100.00% of rows pass the corpus quality gate.
This dataset contains seven question-and-answer pairs derived from the ICMR Standard Treatment Workflow (STW) for hyponatremia. The source document outlines conditions, treatments, and diagnostic approaches related to hyponatremia, including acute and chronic cases. Questions cover topics such as associated conditions, treatment protocols, and fluid intake restrictions. Each answer is a verbatim excerpt from the source, ensuring alignment with the original publication.
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# One-time install: pip install desidata
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import desidata
df = desidata.load("www-icmr-gov-in-2442914bfa18eefbd9ce47468fb3c5f6")
df.head()First 7 of 7 rows
| question | answer | context | answer_start | question_type | knowledge_quality_score | source_document | source_quote | source_page | source_location | confidence | validation_status |
|---|---|---|---|---|---|---|---|---|---|---|---|
| What condition is associated with bicarbonaturia and metabolic alkalosis? | renal tubal acidosis and metabolic alkalosis | 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 | 174 | relationship | 0.970 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726567243_approach_to_hyponatremia.pdf | 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 | 1 | page=1,block=2 | 0.700 | valid |
| What is the recommended 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 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726567243_approach_to_hyponatremia.pdf | 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 | |
| What are the conditions associated with extrarenal 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 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726567243_approach_to_hyponatremia.pdf | 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 listed under euvolemia? | 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 | 0.780 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726567243_approach_to_hyponatremia.pdf | 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 is the correction limit for chronic or unknown hyponatremia within the first 24 hours? | not > 8-10 mM within first 24 hours | 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? | 420 | factual | 0.570 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726567243_approach_to_hyponatremia.pdf | 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. | 1 | |||
| What is the initial dosage of oral Tolvaptan for chronic hyponatremia? | 15 mg on day one and then 30-60 mg per day | 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? | 471 | factual | 0.570 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726567243_approach_to_hyponatremia.pdf | 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. | 1 | |||
| What is the fluid intake restriction recommended for likely chronic hyponatremia? | 500-1000 ml/ 24 hour | 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) | 79 | factual | 0.490 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726567243_approach_to_hyponatremia.pdf | 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 |
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