49. 肉毒桿菌素(botulinum toxin type A) 目前用來治療筋膜炎(myofacial pain syndrome) 注射激發點(trigger point)注射,其作用機轉是經由
(A)減少突觸前 (presynapse) acetylcholine 的釋放
(B)減少突觸前(presynapse) 鈣離子的吸收
(C)永久性阻斷 acetylcholine esterase的作用
(D)阻止運動神經 sodium channel 的開放
(E)破壞運動終板的接受器

45. Examination of a patient with neck and shoulder pain reveals referred pain in the lateral aspect of the forearm, with weakness and dysfunction of the biceps and brachioradialis, and hypoesthesia in the lateral aspect of the forearm and thumb. The patient most likely has a lesion of which nerve root? (A) C7 (B) C6 (C) C5 (D) C4

46. A 25-year-old, obese man complains of a burning pain in the anterolateral thigh. Deep tendon reflexes and findings in a motor examination are normal. There is a slight sensory deficit in the lateral thigh that corresponds to the painful area. What is the most appropriate diagnostic block to perform on this patient? (A) Epidural local anesthetic and sterioid (B) Trigger point injection (C) Lumbar sympathetic block (D) Lateral femoral cutaneous nerve block (E) Illioinguinal nerve block

47. A 27-year-old woman with a history of malignant melanoma and multiple subcutaneous metastases has been successfully managed with slowly increasing doses of MS-Contin (Morphine SR), in conjunction with doxepin and ibuprofen. She calls the pain center to complain of a new onset of increasing nausea, vomiting, and headaches, as well as poor pain control. The most appropriate immediate action would be to (A) speak with the patient by telephone and tell her to increase the MS-Contin (B) see the patient as soon as possible to determine if there is a new, treatable source of pain (C) schedule the patient for an evaluation in your office within the week (D) switch to a fentanyl patch since the patient is nauseated and may be unable to take oral analgesics (E) add ondansetron for nausea and vomiting so she is able to continue to take oral analgesics

48. 下列何者與痛覺神經傳導無關 (A) Dorsal root ganglion (B) Spinothalamic tract (C) Ventral 'poster, and lateral nuclei of the thalamus (D) Precentral gyrus (E) Parietal codex

50. Therapeutic plasma concentrations of a passive fentanyl patch多於貼上皮膚後多久達成? (A) ＜2 hours (B) ＜4 hours (C) 8 hours (D) 12 hours (E) 12-24 hours

1. A0 的圖紙面積為︰(A)1 ㎡(B)1.25 ㎡(C)1.5 ㎡(D)1.75 ㎡

2. B0 的圖紙規格尺寸為(單位 mm)(A)841×597(B)1414×1000 (C)1189×841 (D)297×210

3. 一般圖紙(道林紙、模造紙)的計量單位為「令重」，請問是以多少張全開圖紙為一令？(A)300(B)400(C)500(D)600

4. 下列何者屬於軟質製圖鉛筆？(A)9H、8H(B)3H、H(C)F、HB (D)5B、6B

5. 工程圖是以圖形及文字來表達物件之外形及尺寸資訊，因此在繪圖及 標註尺寸時，最重視下列那一項？(A)簡潔(B)清晰(C)迅速 (D)正確