21. Which statement about “chronic pain and emotion” is wrong?
(A) The psychological impact and behavioural course of painful conditions varies among individuals.
(B) Chronic pain is always associated with depression.
(C) Depression makes social and occupational functioning more difficult and appears to intensify pain.
(D) Sleep disturbance is one of the diagnosic criterial for depression.

17. Which of the following statement concerning “autonomic-endocrine-immune interaction in pain” is least likely? (A) Cytokines are involved in the sensitization of nociceptors during inflammation and may lead to hyperalgesia (B) Proinflammatory cytokines are synthesized and released by macrophages and other immune-related cells (C) IL-4 is categorized as an anti-inflammatory interleukin (D) IL-1, IL-10 and TNF-α are categorized as proinflammatory cytokines (E) TNF-α induces synthesis and release of IL-8, which activates sympathetic terminals that synthesize nociceptors via β2-adrenoceptors

18. The formal presentation of Myofascial Pain syndrome diagnostic criteria includes each of the following, EXCEPT (A) Resolution of the symptoms after Trigger Point Injection with local anesthetic (B) Referral pain is evident (C) Twitch response and Trigger Points are the common features (D) Limited ROM of the affected muscle or muscles (E) Widespread body pain

19. The current guidelines on the management of acute low back pain in primary care include the following, EXCEPT (A) Reassure patients because the prognosis is most favorable (B) Advise or encourage complete bed rest (C) Prescribe analgesics medication if necessary (D) Encourage to stay active (E) Consider spinal manipulation (chiropractic) for pain relief

20. Which of the following statement is wrong in Repetitive Strain Injury (RSI) ? (A) Blood flow and temperature of the affected limb will be reduced at rest (B) RSI is a normally preventable condition (C) There is multiple folds increase in blood flow with exercise in the painful limb (D) Peripheral nerve injury is a recognized cause of regional pain (E) Treatment with analgesics is seldom advocated for RSI except for short periods

22. Which statement about pain is wrong? (A) Pain is an objective, perceptual experience. (B) No iso-morphic relationship exits between tissue damage and pain report. (C) One characteristic differentiating pain from pure sensation is its affective and cognitive components. (D) Pain must be viewed as a complex phenomenon that incorporates physical, psychosocial and behavioral factor

23. Physical dependence is defined by the abstinence syndrome (withdrawal), but which item below is NOT included: (A) abdominal cramps (B) restlessness (C) pupil constriction (D) sweating (E) dysphoria

24. Which measurement for pain is seldom used in pediatric patients? (A) Poker Chip Tool (B) Oucher scale (C) McGill Pain Questionnaire (D) Faces Pain Scale - Revised (FPS-R) (E) Neonatal Facial Action Coding System (NFACS)

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

26. Which following item is a probably more predictive addiction indicator? (A) Obtaining prescription drugs from non-medical sources (B) Requesting specific drugs (C) Unapproved use of the drug to treat another symptom (D) Openly acquiring similar drugs from other medical sources (E) Aggressive complaining about needing more of the drug

27.下列有關老年病患疼痛問題之敘述何者正確? (A)即使有認知功能障礙的老年病患, 仍應該積極處理其疼痛 (B)慢性疼痛問題在老年人之發生率遠高於年輕人 (C)針對手術後疼痛, 老年病患較年輕病患更常主動表達疼痛問題 (D)老年慢性疼痛病患比年輕病患更容易受到憂鬱的影響 (E)以上皆正確