CCRN Sepsis and MODS 3 — Questions and Answers
Question 1: Multiple organ dysfunction syndrome (MODS) is best defined as:
- Progressive dysfunction of two or more organ systems requiring intervention to maintain homeostasis (Correct answer)
- Failure of a single organ in a critically ill patient
- Reversible dysfunction of one organ within 24 hours
- Chronic organ failure unrelated to acute illness
Correct answer: Progressive dysfunction of two or more organ systems requiring intervention to maintain homeostasis
MODS involves altered function of two or more organ systems requiring support.
Question 2: Which organ system is typically the first to fail in the progression of MODS?
- Pulmonary (lungs) (Correct answer)
- Renal (kidneys)
- Hepatic (liver)
- Cardiac (heart)
Correct answer: Pulmonary (lungs)
The lungs are often the first organ to fail, frequently presenting as ARDS.
Question 3: Sepsis-associated acute kidney injury is most directly indicated by which finding?
- Rising creatinine with decreased urine output (Correct answer)
- Elevated white blood cell count
- Increased serum lactate alone
- Falling platelet count
Correct answer: Rising creatinine with decreased urine output
AKI is marked by rising creatinine and oliguria reflecting reduced renal function.
Question 4: Which coagulation abnormality is a hallmark of disseminated intravascular coagulation (DIC) in severe sepsis?
- Simultaneous bleeding and microvascular thrombosis (Correct answer)
- Isolated elevated platelet count
- Shortened PT and PTT
- Decreased D-dimer levels
Correct answer: Simultaneous bleeding and microvascular thrombosis
DIC produces both clotting and bleeding due to consumption of clotting factors.
Question 5: In sepsis-induced hepatic dysfunction, which laboratory finding is commonly seen?
- Rising bilirubin and transaminases (Correct answer)
- Decreased ammonia
- Elevated albumin
- Normalized INR
Correct answer: Rising bilirubin and transaminases
Hepatic dysfunction raises bilirubin and liver enzymes and prolongs the INR.
Question 6: The underlying pathophysiology that drives MODS in sepsis is primarily:
- Dysregulated systemic inflammation and microcirculatory failure (Correct answer)
- A localized bacterial abscess
- Pure cardiogenic pump failure
- Isolated electrolyte imbalance
Correct answer: Dysregulated systemic inflammation and microcirculatory failure
Uncontrolled inflammation and impaired microcirculation cause widespread organ injury.
Question 7: Which scoring tool quantifies the degree of organ dysfunction across six systems in critically ill sepsis patients?
- SOFA score (Correct answer)
- Glasgow Coma Scale
- APGAR score
- Wells score
Correct answer: SOFA score
The SOFA score grades dysfunction across six organ systems to track severity.
CCRN Sepsis and MODS 3
Multiple organ dysfunction syndrome (MODS) is best defined as: