38. Which of the following statement concerning pain assessment is least likely:
(A) Strong test-retest reliability coefficients do not exist for the MiGill Pain Questionnaire (MPQ) PRIs.
(B) Rheumatoid arthritis showed a stable pattern of MPQ scores over a 6-year period.
(C) MPQ has excellent distinction power between sensory and affective dimensons
(D) MPQ is sensitive to interventions designed to reduce pain
(E) MPQ can provide an aid in the differential diagnosis between various pain syndromes

34. Which of the following is the unacceptable statement about paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) : (A)To treat acute postoperative pain and in the chronic situation for treatment of osteoarthritis, there are differences in efficacy between NSAIDs and paracetamol. (B) To treat acute postoperative pain and in the chronic situation for treatment of osteoarthritis, the efficacy of classical NSAIDs and Coxibs (cyclooxgenase-2-inhibitory non-steroidal anti-inflammatory drugs) is similar. (C) If oral NSAIDs are taken for at least 6 months, the risk of an endoscopic ulcer is 1 in 5, of a symptomatic ulcer is about 1 in 70, of a bleeding ulcer is about 1 in150, and of a death from a bleeding ulcer about 1 in 1300. (D)Coxibs reduce the gastrointestinal bleeding risk compared with NSAIDs. The risk of congestive heart failure is twice as high with chronic NSAID therapy, and increases to over 20 in patients with a previous history. (E) Paracetamol acts as a Cox inhibitor in the brain, explaining both its analgesic and its antipyretic actions

35. Which of the following is the acceptable statement about the local anaesthetic blocks and epidurals? (A) In the management of chronic pain, diagnostic nerve blocks may help in locating the origin of pain, but are unreliable as prognostic aids for neurolytic or neurodestructive procedures. (B) Pain originating from malfunctioning CNS pain modulation may also be relieved by a peripheral nerve block. (C) Epidural local anaesthetic blocks cannot reliably predict the effect of spinal cord stimulation. (D)“Pulsed radiofrequency” treatment: lower temperature applied； less effective； fewer adverse effect compared with conventional radiofrequency denervation. (E) All of the above

36 Which of the following statements regarding trigeminal neuralgia is FALSE? (A) It affects the fifth cranial nerve. (B) It is usually bilateral and is more common in men under the age of 50. (C) Etiology includes idiopathic, demyelination, or vascular malformations. (D) The majority of patients describe the classic high-intensity, triggerable pain in association with activities such as eating or talking. (E) Even simple things, such as a cold breeze, can trigger a pain episode.

37. Which statement regarding complex regional pain syndrome (CRPS) is TRUE? (A) Causalgia, or burning pain, is now categorized as CRPS type I. (B) The term “reflex sympathetic dystrophy” (RSD), or CRPS type II, refers to a syndrome similar to causalgia but with a specific nerve lesion. (C) Etiology involve only peripheral over-reactions after nerve and/or soft tissue damage. (D) The signs and symptoms in CRPS are heterogeneous； which reflect underlying sensory, autonomic, and motor dysfunctions. (E) Sympathetic blockade is the golden standard of treatment

39. Examination of a patient with neck and shoulder pain reveals referred pain in the lateral aspect of the forearm, with weakness and dysfunction of the biceps and brachioradialis, and hypoesthesia in the lateral aspect of the forearm and thumb. The patient most likely has a lesion of which nerve root? (A)C4 (B) C5 (C) C6 (D) C7

40. Indications for lumbar epidural steroid injections include all of the following, EXCEPT? (A) Radicular pain with corresponding sensory change (B) Radiculopathy due to herniated disc with failed conservative treatment (C) Acute herpes zoster in the lumbar dermatomes (D) Posterlaminectomy (failed back) syndrome without radiculopathy

41. For which of the following types of pain are antiepileptic drugs most commonly used？ (A)Acute pain (B) Cancer pain (C)Chronic pain syndrome (D)Neuropathic pain (E) Nociceptive pain

42. Descending inhibitory pathways typically involve which of the following neurochemical mechanisms EXCEPT? (A) Noradrenergic (B) Enkephalinergic (C) Serotonergic (D) Cholinergic

43. A parturitient of heroin abuse history ask for painless labor, which one is improper? (A) Meperidine (B) Continuous epidural analgesia (C) Nitrous oxide (D) Butorphanol (E) Intrathecal morphine

44. Which of the following statements regarding corticosteroid use is NOT true? (A) 30-50% of patients on chronic oral corticosteroid therapy suffer from osteoporotic fractures. (B) Corticosteroid users are at increased risk of NSAID-related GI bleeding. (C) Corticosteroid use can be associated with weight gain, hypertension and hyperglycemia. (D) Osteoporosis is only a concern in patients who have been on corticosteroids for over 12 months.