According to WHO, all are true about Reduced osmolarity ORS (in mmol/L) except:

Okay, let's tackle this question. The user provided a question about WHO's Reduced Osmolarity ORS and asked for a detailed explanation. First, I need to recall the composition of ORS according to WHO guidelines. The key here is that the reduced osmolarity ORS was introduced to prevent hyponatremia and reduce stool output.

The correct answer is the one that's false. The standard ORS has 75 mmol/L of sodium, but the reduced osmolarity version has 65 mmol/L. The glucose concentration is 75 mmol/L, which is important for the sodium-glucose cotransport mechanism. Potassium is around 20 mmol/L, and chloride is adjusted accordingly. The total osmolarity is about 245 mOsm/L.

Looking at the options, the incorrect statement would be the one that doesn't match these values. For example, if an option says sodium is 75 mmol/L, that's the old formulation. The reduced one is 65. Similarly, if any option lists a different glucose concentration, that's wrong. Other options might incorrectly state potassium or chloride levels.

I need to explain the core concept about osmolarity and its adjustment in ORS. Then, detail why the correct answer is right by referencing the sodium and glucose concentrations. Then, for each wrong option, explain why their values are incorrect. Finally, the clinical pearl should highlight the change from 75 to 65 mmol/L sodium as a high-yield point for exams.

**Core Concept**
WHO's Reduced Osmolarity Oral Rehydration Solution (ORS) was formulated to reduce hyponatremia and stool output by adjusting electrolyte concentrations. The key change is reduced sodium and glucose compared to standard ORS, enhancing water absorption via the sodium-glucose cotransporter (SGLT1) in the small intestine.

**Why the Correct Answer is Right**
Reduced osmolarity ORS contains **65 mmol/L sodium**, **75 mmol/L glucose**, **20 mmol/L potassium**, and **30 mmol/L citrate**, yielding a total osmolarity of **245 mOsm/L**. The lower sodium concentration improves absorption efficiency and reduces renal solute load, while glucose ensures active sodium transport via SGLT1. Citrate replaces part of chloride to prevent metabolic acidosis.

**Why Each Wrong Option is Incorrect**
**Option A:** Incorrect if it states sodium as 75 mmol/L — the reduced ORS uses 65 mmol/L sodium to avoid hyponatremia.
**Option B:** Incorrect if it lists glucose as 90 mmol/L — the standard is 75 mmol/L to maintain the 1:1 sodium-glucose coupling ratio.
**Option C:** Incorrect if it cites potassium as 10 mmol/L — WHO mandates 20 mmol/L potassium to correct hypokalemia.
**Option D:** Incorrect if it claims osmolarity as 311 mOsm/L — the reduced ORS is 245 mOsm/L, whereas standard ORS is 311 mOsm/L.

**Clinical Pearl / High-Yield Fact**
The **"65-75-20-30" rule**

✓ Correct Answer: A. Glucose -90