36. Which of the following statement concerning painful polyneuropathies with prevalent loss of small fibres is most likely:
(A) Chronic renal failure neuropathy. I.
(B) Diabetes mellitus neuropathy.
(C) Alcoholic neuropathy.
(D) Myeloma neuropathy..
(E) soniazid neuropathy.

32. 下列何者不是偏頭痛(migraine)常見症狀？ (A)單側性疼痛 (B)搏動性疼痛 (C)痛到眼窩後方 (D)噁心嘔吐 (E)對光與聲音敏感

33. 下列何者不是典型三叉神經痛(classic trigeminal neuralgia)的臨床特徵? (A)發作前常無預兆 (B)表淺的、尖銳的、針刺樣或撕裂樣的劇烈疼痛 (C)持續超過 10 分鐘以上 (D)在個別患者發作型態變化不大 (E)無神經缺陷

34. 下列何者為最常見的頭痛型態？ (A)偏頭痛(migraine) (B)緊張性頭痛(tension-type headaches) (C)叢集性頭痛(cluster headaches) (D)頸因性頭痛(cervicogenic headache) (E)次發性頭痛(Secondary headaches)

35. 下列關於原發性口腔灼熱症候群(burning mouth syndrome)的描述，何者為非? (A)症狀局限於舌頭處 (B)表現灼熱及感覺異常 (C)常伴隨味覺功能障礙 (D)涉及對感覺神經元和自主神經元的損害 (E)藥物治療包含三環類抗抑鬱藥、抗癲癇藥或鴉片類藥物

37. Which of the following is the acceptable statement about neurodestructive RF lesions? (A) These temperatures are resulted from friction heat. (B) The size of RF lesion with 22 gauge RF needle is around with a radius of 5 mm (C) The heat is generated on the tip of RF needle. The RF needle then heat up the tissues. (D) The RF pernanent neuro-destructive lesion is formed when neural temperatures exceed 42 C (E) All of the above

38. Which of the following suggestion is not advisable for the use of opioids in children with cancre 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 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 .

40. 有關 Opioid 的敘述，下列何者為錯誤? (A) Codeine 與 tramadol 皆屬於 weak opioid，但二者不是同一級管制藥。 (B) 大約等效止痛劑量換算: 10mg morphine= 50mg tramadol= 7.5mg oxycodone。 (C) Opioid rotation(將一種 opioid 等效換成另一種 opioid)不會改善止痛強度。 (D) Opioid 可能會造成 muscle rigidity，myoclonus 與 delirium。 (E) 成癮性 opioid 用於慢性非癌疼痛，在台灣受到嚴格管控。

41. 有關 NSAID 的敘述，下列何者為錯誤? (A)NSAID 的副作用包含: Hypertension, Renal failure, Bleeding, Asthma。 (B) Cyclooxygenase(COX)的產物是 hyperalgesia 的 mediators。 (C) Topic NSAID 有被建議當作關節炎的第一線用藥。 (D) COX 的止痛機制與 prostaglandin 有關但與 endocannabinoids 無關。 (E) Paracetamol 的止痛會透過 TRPV1。

42. 有關 antidepressant 與 anticonvulsant 止痛藥的敘述，下列何者為非? (A) antidepressant 對帶狀庖疹後疼痛，糖尿病神經病變與中樞疼痛有治療效果。 (B) 三環抗憂鬱劑的副作用有口乾，姿態性低血壓，嗜睡與椎體外症候群。 (C) 抗憂鬱劑是同時具有疼痛改善與抗憂鬱的效果，而不是只透過抗憂鬱的效果來止痛。 (D) anticonvulsant 的止痛是透過鈉離子通道與 GABA pathway 等多重作用完成。 (E) 三叉神經痛，糖尿病神經病變也可用 anticonvulsant