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.

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

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

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

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。

47. A 52-year-old man complains of a sudden onset of severe，stabbing pain in the left jaw and cheek that subsides in less than a minute. He is pain-free during the intervals between attacks. Activities such as combing his hair and shaving can cause the onset of this facial pain. He is otherwise healthy. The most likely diagnosis is? (A) Atypical facial pain (B) Vascular facial pain (C) Postherpetic neuralgia (D) Trigeminal neuralgia

48. 一個因外傷而將左下腳(left lower leg)截肢的 15 歲少年，最後發展 phanton pain (幻肢痛)， 雖經多種方法止痛，仍未獲得疼痛舒緩，因此接受脊椎神經刺激術(spinal cord stimulation)， 請問應放在哪一個脊椎範圍為佳？ (A) 頸椎位置 (B) 中至下頸椎位置 (C) 上至中胸椎位置 (D) 中至下胸椎位置 (E) 腰椎位置