46. 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

42. Which of the following description about spinal cord plasticity and pain is incorrect? (A) Some spinal nociceptive neurons receive convergent input from high- and low- threshold sensory fibers thus called wide–dynamic range neurons (B) Glutamate is the major fast excitatory neurotransmitter in all nociceptive afferent nerve fibers. Glutamate can bind to three types of ionotropic glutamate receptors and to G protein–coupled metabotropic glutamate receptors to modify neuroexcitability. (C) Hyperalgesia and allodynia can even be induced in humans in the absence of any sensory stimulus, such as during prolonged application of opioids or on abrupt withdrawal of opioids. (D) Spinal nociception is under powerful control from descending inhibitory and facilitatory pathways. Under normal conditions, descending facilitation appears to prevail over inhibitory pathway.

43. 下列關於 opioid rotation 或 opioid switch，哪一種敘述較不正確： (A) opioid switch/rotation 意思是指改變鴉片藥物的給藥途徑，可以提高止痛效果 (B)動物實驗上可發現，鴉片受器剔除小鼠仍可以保留部分對 fentanyl 注射的止痛效果 (C)理論基礎是基於人體對 opioid receptor 的 binding profile 及 affinity 具有基因多樣性 (heterogenecity). (D) 臨床上已成為改善癌症病人的嗎啡類藥物效果的常用方式 (E) tramadol 換成 morphine 不能稱為 opioid switch

44. 下列關於癌症病人的 breakthrough pain，下列敘述何者較不正確： (A) 包括了 incident pain 及 spontaneous pain (B) 一般不把"end-of-dose failure of analgesic"歸類在 breakthrough pain (C) 疼痛的特性包括了 somatic pain, visceral pain, neuropathic pain 或 mixed type (D) fentanyl buccal film 可以用來控制中重度的 breakthrough pain (E) breakthrough pain 的發生機率並不大，一般只出現在癌症末期或瀕死病人

45. 利用手術或介入性阻斷技術減少癌症疼痛的方式，下列敘述何者效果最差： (A) 以 internal surgical fixation 減少脊椎病理性骨折的疼痛 (B) 以 epidural steroid 減輕腫瘤浸潤引起的 lumbosacral radiculopathy (C) 以 IV-PCA 減輕 radiation-induced brachial plexopathy (D)以 neurolytic celiac plexus blockade 控制胰臟癌引起的腹痛 (E) 以 intrathecal morphine pump 治療 peritoneal carcinomatosis-induced pain

47. Which of the following statement concerning painful polyneuropathies with prevalent loss of small fibers is most likely: (A) Chronic renal failure neuropathy. (B) Diabetes mellitus neuropathy. (C) Alcoholic neuropathy. (D) Myeloma neuropathy. (E) soniazid neuropathy.

48. About epidural steroid injection, which one of following statements is wrong? (A) Spinal stenosis is an indication for epidural steroid. (B) Do not use for non-specific low back pain. (C) Do not repeat more than three times per year. (D) May cause pain from chronic arachnoiditis. (E) Efficacy is less with radicular pain that has lasted longer than 3 months.

49. Pain is a frequent consequence of spinal cord injury (SCI). Which of the following statement is least likely: (A) Below-level neuropathic pain is most likely described as severe or excruciating months or years following initial injury. (B) Damage to the spinothalamic tracts is an important ingredient in the development of neuropathic pain following SCI. (C) Chronic musculoskeletal pain is common in tetraplegic patients after SCI. (D) Patients with cervical SCI are at risk of developing CRPS affecting upper limbs. (E) Below-level neuropathic pain is also referred to deafferentation pain.

50. Effects on postoperative morbidity of regional anaesthetic or analgesic techniques compared with those of general anaesthesia and systemic postoperative analgesics may reduce the following complications, except: (A) pulmonary embloism (B) myocardial complications (C) pulmonary infectious complications (D) cerebral complications (E) other thromboembloic complications

1.企業在實現其目標的過程中願意接受的風險程度，稱為下列何者？ (A)風險偏好(risk appetite) (B)風險係數(risk correlation) (C)風險因應(risk response) (D)風險辨識(risk identification)

2.下列何項非屬美國國會崔德威委員會 COSO 報告強調之內部控制構成要素？ (A)風險評估 (B)控制活動 (C)稽核功能評估 (D)資訊與溝通