40. Based on published monotherapy clinical trials, which one has negative results for treating postherpetic neuralgia?
(A) Amitriptyline
(B) Gabapentin
(C) Oxycodone
(D) Carbamezepine
(E) Topical lidocaine patch

36. 抗憂鬱劑常被用在治療慢性神經病理性疼痛緩解，以下有關於此類藥物之敘述何者為非? (A) 三環抗憂鬱劑是慢性疼痛治療的首選藥物。 (B) Amitriptyline 可同時抑制 Serotonin 和 Noradrenaline 兩神經傳遞物質之回收，效果較其他選擇性回收抑制劑之治療效果佳，其 NNT 為 14 左右。 (C) 三環抗憂鬱劑之止痛效果，主要並非來自於其鎮靜或是抗焦慮之作用。 (D) 近來之研究發現三環抗憂鬱劑也具有抑制鈉離子通道及 NMDA 受體之作用。 (E) 青光眼及攝護腺肥大是使用三環抗憂鬱劑的禁忌症。

37. 下列有關 spinal cord injury (SCI)之後引起之疼痛，下列敘述，何者較不正確？ (A) 慢性 SCI 疼痛，大約佔 SCI 之 65％ (B) 慢性 SCI 疼痛病人當中，大約有 1/3 病人具有嚴重疼痛 (C) 可區分為 musculoskeltal pain，visceral pain 以及 nreuropathic pain (above-level pain、 at-level、below-level) (D) 其中以 neuropathic pain 最常見，約佔慢性 SCI pain 之 58％ (E) 一般而言，眾多藥物及治療方式當中，較難有長時間而滿意的止痛療效

38. Which of the following is Wrong? (A) Opioids activate central μ opioid receptor which causing decreased peristalsis, decreased intestinal secretions, and increased sphincter tone. (B) Pain act as a physiologic antagonist to respiratory depression. (C) Up to two-thirds of patients experience nausea or vomiting during initiation of opioid therapy. (D) Antihistamines, opioid antagonists, propofol and ondansetron have been used for the treatment of pruritus.

39. 此超音波顯像圖示中，針尖位置於何處是最合適於星狀神經節注射？ (A) 1 (B) 2 (C) 3 (D) 4 (E) 5

41. The major problems in using NSAIDs in acute use did not include: (A) allergic reaction (B) renal failure (C) coagulation problems (D) impact on healing processes, particularly of bone (E) all of the above were concerns with NSAIDs

42. Which of the following statement concerning central pain is least likely: (A) Central pain is defined as pain caused by a lesion or dysfunction in the CNS. (B) The most common causes are cerebrovascular lesions, multiple sclerosis and SCI. (C) In stroke there is a particularly high prevalence in developing central pain among patients with ischaemic and haemorrhagic cerebrovascular lesions. (D) In stroke the central pain is most frequently a hemipain. (E) Excessive activity in glutaminergic synapses appears to be part of the mechanism underlying central pain.

43. 以下針對超音波影像引導之疼痛治療中，各式使用的探頭(probes)敘述，何者為非？ (A) 弧形探頭的頻率最低，所引導針尖到達之標的治療組織最深。 (B) 微型探頭的頻率最高，所引導針尖到達之標的治療組織最淺。 (C) 線型探頭的頻率約在 5~12MHz 左右。 (D) 腰椎小面關節注射(facet joint injection)因範圍很小，故以使用微型探頭最為適當。 (E) 通常組織穿透力高的探頭，解析度會較為遜色。

44. 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

45. Which of the following is the acceptable statement about Neurodestructive RF Lesions? (A) The RF permanent neurodestructive lesion is formed when neural temperatures exceed 42℃. (B) These temperatures are a result of friction heat (C) The heat is generated on the tip of RF needle. The RF needle then heat up the tissues. (D) The size of RF lesion with 22 gauge RF needle is around with a radius of 5 mm (E) All of the above

46. 下列有關 Complex regional pain syndrome(CRPS)的敘述何者不正確？ (A) 骨折後，發展成為 CRPS I 的 incidence 約為 1-2%。 (B) 女性比男性更容易發生 CRPS。 (C) CRPS typeII 病患其通常進展為其有非對稱性遠端肢體疼痛及腫脹但並沒有神經損傷。 (D) CRPS 病患有相當高比例，同時罹患憂鬱症及焦慮、症。然而目前並沒有證據顯示 CRPS 是種心因性問題。 (E) 有50%慢性CRPS I病人在半邊身體或患肢同側上方發展為hypoaesthesia及hypoalgesia。