9.Which NSAID has the lowest risk of GI bleeding？
(A) Diclofenac.
(B) Piroxicam.
(C) Indomethacin.
(D) Celebrex.
(E) Ketoprofen

5. Which of the following statement concerning “central pain” is least likely: (A) Central pain is dominated by abnormalities in the sensibility to temperature (B) The most common cause is traumatic spinal cord injuries (C) Central pain is defined as pain caused by a lesion or dysfunction in the CNS (D) In stroke the onset of pain is early (E) In stroke the pain is most frequently a hemipain

複選題6. Which of the following is the acceptable statement about pathogenesis of FMS? (A) There is evidence to suggest that FMS is a disorder of abnormal processing of sensory information within the central nervous system. (B) Several neurochemical mediators of pain, substance P, nerve growth factor, dynorphin A, glutamate, nitric oxide, serotonin and noradrenaline are viewed as pronociceptive because they carry or amplify afferent signals, leading to the brain perception of increased pain. (C) The elevation of cerebrospinal fluid substance P in FMS is due to lowered activity of cerebrospinal fluid substance P esterase because the rate of cleavage of libeled substance P by FMS cerebrospinal fluid was lower than normal. (D) In different subtypes of FMS, it is believed that nerve growth factor may be responsible for the elevated cerebrospinal fluid substance P through its effects on central sensitization and neuroplasticity. (E) A specific Gi-protein–coupled receptor in peripheral blood leukocytes was found to be dysfunctional in patients with FMS. This resulted in lower baseline, also depressed intracellular levels of cyclic AMP and proposed as a diagnostic test for FMS.

7. What is the following description about tension-type headache is FALSE? (A) may be associated with stress (B) associated with vomiting (C) bilateral (D) most common in adolescence (E) pain may involve teeth, forehead & neck

8. In neuropathic pain, the hyperexcitability demonstrated by wide-dynamic range cells in the dorsal horns seems to be related to increase basal release of excitatory amino acids, such as (A) Dopamine (B) Glutamate. (C) Acetylcholine. (D) GABA. (E) Norepinephrine. 

10. About the surgical management of pain, which one statement of the followings is wrong? (A) Neuropathic pain due to a compressive lesion may be completely relieved by surgery, particularly if there has been little damage. (B) There may be severe continuing pain with relatively minor damage (e.g. root compression). (C) For the majority of patients with neuropathic pain, the realistic goal of treatment, in a multidisciplinary pain clinic, is total analgesia and improvement in functional status. (D) Any operation for treating pain should aim to be specific, localized into the pain area, carry minimal risk and long-lasting. (E) Neurosurgeons generally try the most peripheral procedures before working centrally within the CNS, while giving preference to non-neuroablative operation, if possible.

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

12. Indications for lumbar epidural steroid injections include all of the following, EXCEPT? (A) Post-laminectomy (failed back) syndrome without radiculopathy (B) Radicular pain with corresponding sensory change (C) Radiculopathy due to herniated disc with failed conservative treatment (D) Acute herpes zoster in the lumbar dermatomes

13. Which of the following is the acceptable statement about neurodestructive RF lesions? (A) These temperatures are a result of friction heat. (B) The size of RF lesion with 22 gauge RF needle is around with a radius of 5 mm (C) The heat is generated on the tip of RF needle, the RF needle then heat up the tissues. (D) The RF permanent neurodestructive lesion is formed when neural temperatures exceed 42℃ (E) All of the above

14. Which of the following statement concerning hypnotic analgesia is least likely: (A) Hypnosis has been highly associated with theta activity (4~8 Hz) using EEG methods. (B) Hypnotic analgesia can be understood as the result of a placebo manipulation, and it is not more than just relaxation. (C) Increases in hypnotic relaxation are associated with increases in regional cerebral blood flow in the occipital cortex. (D) Deep relaxation, dissociated imagery and focused analgesia produced significant reductions on all pain-related measures. (E) Descending projections from amygdale, PAG and locus coeruleus contribute to modulate nociceptive processes in the brain stem and the spinal cord.

15. About the intrathecal drug delivery system, which of the following statements is NOT correct? (A) It places medication directly into the cerebrospinal fluid that surrounds the spinal cord. (B) Morphine delivered directly to the intrathecal space is particularly effective because it does not have to circulate systemically to reach the CSF and the dorsal horn of the spinal cord. (C) As a result, much smaller doses are needed (e.g., approximately 1/30 of an oral morphine dose), and the frequency of side effects is reduced. (D) Advantages of intrathecal therapy in pain includes effective pain relief, reduced side effects for patients, reduced consumption of systemic medication, improved ability to perform ADLs, and enhanced quality of life.