44. 有關 complementary and alternative medicine(CAM)在疼痛的敘述，下列何者為非?
(A) 針灸用於各種的疼痛，治療的結果不一。
(B) Chiropractic treatment (整脊)可用於治療背部的疼痛，但其結果並不一致。
(C) Massage therapy 在背部疼痛可能有效，但缺少嚴格的臨床試驗。
(D) Herbal medicine (中草藥)種類繁多，但多天然物，毒性低，但效果不一。
(E) 太極拳用於關節炎的治療，証據不明顯。

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

43. 有關脊椎神經刺激術(SCS)的止痛敘述，下列何者為非? (A) SCS 是植入電極的疼痛治療方式，是 gate control 理論的應用。 (B)缺血性疼痛、複雜區域疼痛與糖尿病神經病變以 SCS 治療，成功機會較高。 (C)會陰部疼痛與脊椎部份傷害的疼痛，無效機會高。 (D) 病人存活時間要大於 6 個月。 (E) 有裝心臟節器的病人也適合。

45. Which of the following is not true about post-mastectomy pain? (A) Mastectomy may result in chronic pain in as many as half of those patients. (B) This pain often starts immediately or a few days postoperatively. (C) This pain is usually neuropathic in character. (D) It is suspected that the intercostobrachial nerve is often damaged during axillary node dissection (E) The incidence of phantom breast syndrome 1 year after surgery is less than 5%.

46. According to the long-form McGill Pain Questionnaire (MPQ) pain rating index scores, which of the following acute pain status is rated the highest pain score? (A) Amputation of digit (B) Labor pain (C) Abdominal gynecological surgery (D) Fracture. (E) Lower abdominal surgery (males)

47. Which of the following symptom is not often seen in patients with physical dependence (abstinence syndrome -(withdrawal) ) ? (A) abdominal cramps (B) constipationn (C) vomiting (D) pupil dilatation (E) sweating

48. About chemical neurolytic nerve blocks, which one of following statements is wrong? (A) Phenol or ethanol is usually used for chemical denervation. (B) The duration of these blocks is often disappointingly brief. (C) They may induce deafferentation-neuropathic type pain. (D) They are often indicated for patients with chronic pain and a normal life expectancy. (E) They can be used in patients with advanced cancer disease.

49. Which of the following combination of lesion site with referral site describing pain referral is not common in cancer patients suffering from cancer pain? (A) (Diaphragmatic irritation) and (Shoulder) (B) (Urothelial tract) and (Inguinal region and genitalia) (C) (C7–T1 vertebrae) and (Interscapular) (D) (L1–2) and (Sacroiliac joint and hip) (E) all of the above are common found in patients with cancre pain

50. About image-guided lumbar sympathetic block, which the following indication is not proper? (A) Sympathetically maintained pain (B) Reflex sympathetic dystrophy (C) Phantom low limb pain (D) Raynaud’s disease (E) Chronic pancreatitis