36. Which of the following is not a common manifestation of the myofascial pain syndrome?
(A) Regional body pain and stiffness
(B) Abnormal findings on neurological examinationl
(C) Limited range of motion of the affected muscle
(D) One or more trigger points
(E) Referral (triggering) pain from a trigger point to a zone of reference.

32. 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μreceptor partial agonist 及κantagonist 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μagonist 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

33. 下列對於肌筋膜疼痛及纖維肌痛的比較，何者錯誤：

34. MODULATION OF TRIGEMINAL NOCICEPTION 與何者相關？ (A) Segmental modulation (B) Descending modulation from the brain stem. (C) Diffuse noxious inhibitory control. (D) V Top-down modulation (E) all

35. Which of the following common manifestations of fibromyalgia syndrome has the lowest prevalence? (A) Widespread pain (B) Peripheral pain generators (C) Fatigue (D) Irritable bladder syndrome (E) Sleep disorder

37. Which of the following combination of lesion site with referral site describing pain referral is not common in cancer patients suffering from cancer pain? (A) (Diaphragmatic irritation) and (Shoulder) (B) (Urothelial tract) and (Inguinal region and genitalia) (C) (C7–T1 vertebrae) and (Interscapular) (D) (L1–2) and (Sacroiliac joint and hip) (E) all of the above are common found in patients with cancre pain

38. Which of the following suggestion is not advisable for the use of opioids in children with cancer pain? (A) Use the oral route first in most circumstances (B) Treat constipation pre-emptively. (C) If side effects are bothersome with one opioid, consider switching to another one. (D) Use sufficient doses to keep the patient comfortable should be avoided due to the possible occurrence of adverse effects (E) Use the oral route first in most circumstances.

39. Which of the following oral opioids is not recommended for padiatric patients with cancer pain? (A) morphine (B) hydromorphone (C) oxycodone (D) meperidine (pethidine) (E) all of the above can be prescribed for pediatric patients with cancre pain

40. Adjuvant analgesics are often prescribed for managing caner pain, but which of the following drug – indication is not considered? (A) NSAIDs for Soft tissue pain (B) Anticonvulsants for Neuropathic pain (C) Steroids for Soft tissue pain (D) Baclofen for Muscle spasm (E) Benzodiazepines for Muscle spasm

41. Which of the following cell type sense the initial “endanger signal” and participates in the initial phase of pathogenesis of the nerve injury induced neuropathic pain? (A) Microglia (B) Spinal lamina I and II neuron (C) Astrocyte (D) oligodendrocyte

42. Which of the following description about spinal cord plasticity and pain is incorrect? (A) Some spinal nociceptive neurons receive convergent input from high- and low- threshold sensory fibers thus called wide–dynamic range neurons (B) Glutamate is the major fast excitatory neurotransmitter in all nociceptive afferent nerve fibers. Glutamate can bind to three types of ionotropic glutamate receptors and to G protein–coupled metabotropic glutamate receptors to modify neuroexcitability. (C) Hyperalgesia and allodynia can even be induced in humans in the absence of any sensory stimulus, such as during prolonged application of opioids or on abrupt withdrawal of opioids. (D) Spinal nociception is under powerful control from descending inhibitory and facilitatory pathways. Under normal conditions, descending facilitation appears to prevail over inhibitory pathway.