Which of the following is an example of secondary MODS?

• A. Renal failure following trauma
• B. Pulmonary contusion from steering wheel collision
• C. Sepsis-induced MODS
• D. Liver injury without systemic response

Answer: (A)

Secondary MODS occurs when organ dysfunction develops as a consequence of a systemic inflammatory response and perfusion abnormalities after a primary insult, rather than from a direct injury to that organ. In the trauma setting, the kidneys can fail not because they were directly injured, but because widespread inflammation, shock, and impaired blood flow damage renal function. This fits secondary MODS: the kidney failure is part of a cascade that follows the initial trauma, not a direct renal injury.

Pulmonary contusion is a direct injury to the lung from the trauma itself, representing a primary insult to that organ rather than a secondary cascade. Sepsis-induced MODS involves widespread organ failure driven by infection—often considered MODS driven by a systemic insult, not a secondary cascade after another injury. Liver injury without a systemic response lacks the systemic inflammatory component needed to produce MODS.