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.

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

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.

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

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.

42. Which of the following statement about tramadol is wrong? (A) Oral tramadol has high bioavailability in the range of 80~90%. (B) Tramadol has good efficacy for neuropathic pain and fibromyalgia. (C) The risk for respiratory depression is lower than morphine at equianalgisic doses. (D) Nausea and vomiting seldom occur in patients with tramadol. (E) The tramadol is affected by cytochrome P450 2D6 activity.

43. Which of the following statement concerning “joint pain” is least likely? (A) In a normal joint, only intense pressure on the joint and movements exceeding the working range elicit pain. (B) Under pathological conditions such as joint inflammation, hypersensitivity of the nociceptive system occurs frequently and leads to pain on palpation. (C) Mechanical sensitization of joint nociceptors is generated by numerous inflammatory mediators, including prostaglandins and cytokines. (D) Spinal sensitization involves excitatory amino acids, neuropeptides, and spinal prostaglandins. (E) Better understanding of pain mechanisms can't improve pain therapy.

44. Which one of the following statement is most appropriate? (A) Gabapentin is an anticonvulsant and analgesic. (B) Minocycline is not an antibiotic. (C) Nifedipine (adalat) is a T-type Na+ channel opener. (D) ∧-Conotoxins are derived from snakes..