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

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

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.

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.

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

1. 對於海上搜救之義務與權利，除「一九七九年海上搜索與 救助國際公約」外，何公約亦有明確條文規範？ (A) MARPOL 73/78 (B) SOLAS 1974 (C) ILO 147 (D) COLREGS 1972

2. 下列何者係「一九七九年海上搜索與救助國際公約」之附錄？ (A) 商船搜救手冊 (B) 船長醫療指南 (C) 商船船舶報位系統指南 (D) 自動互助船舶救助系統