35. Which of the following event is not related to Microglia to develop pain hypersensitivity following peripheral nerve injury?
(A) up-regulated P2X4R expression (P2X4R+)
(B) ATP stimulation in the presence of extracellular Ca2+ causes the P2X4R to open a non-selective cation-permeable channel
(C) p38 mitogen-activated protein kinase mediates further Microglial Signaling
(D) release of Brain-Derived Neurotrophic Factor (BDNF)
(E) all of the above are involved to develop pain hypersensitivity following peripheral nerve injury.

31. A 61-year-old woman presents to the pain clinic with a chief complaint of left shoulder and arm pain 3 years after undergoing radiation therapy for breast cancer. Physical examination reveals lymphedema of the left axilla with noticeable skin changes. Examination of the left supraclavicular area precipitates a sharp pain that radiates down her left arm. Which of the following is her likely diagnosis? (A) Tumor metastasis (B) Cervical radiculopathy (C) Reflex sympathetic dystrophy (D) Thrombangitis obliterans (E) Radiation-induced plexopathy

32. Which medication below is not suggested in fibromyalgia syndrome (FMS): (A) Non-steroidal anti-inflammatory drugs (ibuprofen, naproxen) (B) Pregabalin (C) Tricyclics (amitriptyline, nortriptyline, doxepin, cyclobenzaprine) (D) Opioids (E) All of the above treatments are suggested for pain management of OA

33. Choose one wrong description about pain assessment. (A) McGill Pain Questionnaire (MPQ) had been used in Chinese (B) Short-Form MPQ consists both sensory and affective categories. (C) Neuropathic pain also has specific pain questionnaire, like DN4. (D) Visual analog scales (VASs) measure only in pain intensity. (E) Neuropathic pain and non-neuropathic pain evaluation cannot be

34. Which is NOT true regarding cluster headache? (A) ipsilateral ptosis, miosis, or nasal congestion might occur (B) with or without aura (C) usually unilateral (D) none of the above

36. A rise in post-synaptic Ca2+ concentration is an essential central step for virtually all forms of LTP. The rise of post-synaptic Ca2+ concentration is not attributed to (A) NMDA receptors (B) T-type VGCCs (voltage-gated calcium channel) (C) Ca2+-permeable AMPA receptors (D) P2X4R (E) release of Ca2+ from intracellular Ca2+ stores

37. When Rexed’s laminae was applied divide the spinal cord to different laminae. Which of the following description was wrong? (A) Lamina II is also known as the substantia gelatinosa (B) most A-δ fiber will transmit the noxious sensation to lamina I and V (C) most C fiber will transmit the noxious sensation to lamina I and II (D) A-δ fiber and C fiber will transmit innocuous sensation to different laminae from noxious sensation (E) all of the above are correct description

38. For Chronic pain patients (CPPs), which of the following description is wrong: (A) In tertiary treatment facilities, depression has been reported in 10-100% of CPPs (B) Successful treatment of depression reduce the effect of pain interference. (C) Anxiety disorders are common in CPPs (D) The incidence of de novo opioid addiction is increased in CPPs (E) CPPs should be offered smoking cessation treatment.

39. Coxibs cause less adverse effect than NSAIDs except which of the following one? (A)Upper GI bleeding (B) Anemia (C) Asthma (D) Congestive heart failure (E) Lower GI bleeding

40. Which of the following commonly used opioids has the highest oral bioavailability? (A) hydromorphone (B) morphine . (C) pethidine (D) codeine (E) methadone

41. Which of the following statement about post-herpetic neuralgia (PHN) is wrong? (A) The most common sites for PHN are the mid-thoracic dermatomes and ophthalmic division of the trigeminal nerve. (B) Men are more often affected than women. (C) The pain is usually described as burning or electric shock-like. (D) The risk for PHN increase with age. (E) Carbamazepine may not be appropriate in PHN.