19. If we apply light touch stimulus to lesion side in painful neuropathies, it will evoke neuropathic pain, which afferent fiber is involved among the followings?
(A) A-alpha fiber
(B) A-beta fiber
(C) A-delta fiber
(D) C fiber
(E) A-delta and C fiber

15. Regarding antidepressant analgesics, which of the following statement is least likely: (A) According to NNT data in treating postherpetic neuralgia, imipramine has slightly better analgesic effect than oxycodone. (B) Desipramine (25-300 mg/day, oral) has low potency of anticholinergic effect and sedation. (C) Fluoxetine (5-40 mg/day, oral) has no anticholinergic and sedative effects. (D) Venlafaxine is relatively free of muscarinic cholinergic, histaminic and alpha-adrenergic receptor effects. (E) The analgesic effect of antidepressants in treating neuropathic pain is dependent of its antidepressant action.

16. Based on clinical situations, which kind of opioids owns the highest oral bioavailability: (A) Hydromorphone (B) Morphine (C) Pethidine (meperidine) (D) Oxycodone (E) Tramadol

17. About epidural steroid injection, which one of following statements is wrong? (A) Spinal stenosis is an indication for epidural steroid. (B) Do not use for non-specific low back pain. (C) Do not repeat more than three times per year. (D) May cause pain from chronic arachnoiditis. (E) Efficacy is less with radicular pain that has lasted longer than 3 months.

18. Among the following pain disorders, which will produce the highest pain rank index (PRI) by the McGill Pain Questionnaire? (A) Trigeminal neuralgia (B) Pericoronitis (C) burning pain syndrome (D) Reversible pulpitis (E) Temporomandibular disorders (TMD)

20. 關於鴉片類藥物的敘述，下列何者最不正確？ (A) Hydromorphone 效力比 morphine 強 3-5 倍(口服)，且具有 NMDA 受體拮抗劑與血 清素再吸收抑制(serotonin reuptake inhibitor)的特性 (B) Buprenorphine 具有 μ receptor partial agonist 及 κ antagonist 之性質 (C) Meperidine(pethidine)具有高度親脂性，容易引發「尋藥行為」(drug-seeking behavior) (D) Tapentadol 具有 μ agonist 與 noradrenaline reuptake inhibitor 之性質 (E) 以皮下作為給藥路徑可以提供緩慢穩定的吸收，唯給藥量不宜超過 5 mL/hr

21. Which of the following is the acceptable statement about the local anaesthetic blocks and epidurals? (A) In the management of chronic pain, diagnostic nerve blocks may help in locating the origin of pain, but are unreliable as prognostic aids for neurolytic or neurodestructive procedures. (B) Pain originating from malfunctioning CNS pain modulation may also be relieved by a peripheral nerve block. (C) Epidural local anaesthetic blocks cannot reliably predict the effect of spinal cord stimulation. (D) “Pulsed radiofrequency” treatment: lower temperature applied； less effective； fewer adverse effect compared with conventional radiofrequency denervation. (E) All of the above

22. What is the following description about tension-type headache is FALSE? (A) may be associated with stress (B) associated with vomiting (C) bilateral (D) most common in adolescence (E) pain may involve teeth, forehead & neck

23. Which neurological signs and symptoms of complex regional pain syndrome (CRPS) among the followings is the highest? (A) Hyperesthesia/allodynia (B) Coordination deficits (C) Tremor (D) Muscle spasm (E) Paresis

24. Which following statement about pain assessment is true? (A) The McGill Pain Questionnaire (MPQ) has become the most widely used clinical and research tool for measuring pain. (B) The McGill Pain Questionnaire is designed to assess the multidimensional nature of pain experience and has been demonstrated to be a reliable, valid and consistent measurement tool. (C) Descriptors in the McGill Pain Questionnaire fall into 4 major groups, including: sensory, affective, evaluative, and miscellaneous (D) The main disadvantage of VAS is the assumption that pain is a unidimensional experience that can be measured with a single-item scale. (E) All the above are true.

25. Which statement of the followings is wrong? (A) Pain cannot be explained purely by a simple perception-action model. (B) Pain is unlikely be underpinned by a single unified motivation value system. (C) Pain is likely to be underpinned by a number of distinct systems of action, including innate, habit-like, and goal-directed systems. (D) Understanding decision making is likely to be critical for understanding the complexity of intrinsic pain modulation pathways. (E) All the above are correct