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.

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

複選題45. Which of the following statements concerning the difference between phenol and alcohol when used in neurolytic blocks is/are FALSE? (A) Phenol takes 15 minutes for neurolysis whereas alcohol’s neurolytic effect is immediate. (B) Phenol usually does not produce pain on injection. (C) Intrathecal alcohol is hypobaric, whereas phenol is hyperbaric. (D) Phenol is approximately twice as efficacious as alcohol.

46. Which of the following statements regarding morphine is true? (A) Its metabolite, morphine-3-glucuronide, is a potent analgesic. (B) In patients with renal failure, morphine-3-glucuronide may be accumulated and induce stronger analgesic effects. (C) Morphine is absolutely contraindicated in non-cancer pain management. (D) The constipation induced by morphine treatment can be reversed by naloxone

47. A patient suffered from chronic low back pain with radiating to buttock, poster lateral thigh and lateral aspect of lower leg. Muscle weakness was observed in the extensor hallucis longus and tibialis anterior. Which lumbosacral root compression is the most likely？ (A) L2 root compression (B) L3 root compression (C) L4 root compression (D) L5 root compression (E) S1 root compression

48. About the following CT-guided intervention, which indication is NOT proper? (A) Sympathetically maintained pain (B) Reflex sympathetic dystrophy (C) Chronic pancreatitis (D) Raynaud syndrome (E) Failed back surgery syndrome.

49. A 61-year-old woman presents to the pain clinic with a chief complaint of left shoulder and arm pain for 3 years after undergoing radiation therapy for breast cancer. Physical examination reveals lymphedema of the left axilla with noticeable skin changes. Examination of the left supraclavicular area precipitates a sharp pain that radiates down her left arm. Which of the following is likely diagnosis for her clinical presentation ? (A) Radiation-induced plexopathy (B)Tumor metastasis (C) Reflex sympathetic dystrophy (D) Cervical radiculopathy (E) Thrombangiitis obliterans

50.Which of the following activities will exacerbate pain the most in an elderly patient with severe spinal stenosis? (A) Walking uphill (B) Walking downhill (C) Riding a bicycle (D) Bending forward Standing