31.下列對 CRPS (complex regional pain syndrome) 的敘述何者不正確？
(A)有灼熱痛 (burning pain)
(B)合併持續疼痛(ongoing pain)及突發性疼痛(breakthrough pain)
(C)對嗎啡類止痛藥的反應不錯，常須合併這類藥物使用
(D)疼痛也會合併肌痛點的表現
(E)治療的首要目標為恢復正常生活作息

32.一位末期肝癌疼痛的病患，因口服嗎啡已經造成嚴重的嘔吐，考慮改由脊髓腔內(intrathecal) 持續給藥，因其每天劑量達 600 mg，經換算後脊髓給藥劑量應為每天約： (A) 1 mg (B) 2 mg (C) 6 mg (D) 10 mg (E) 20 mg

33.Nociceptive pain： (A) Occurs only in laboratory animals. (B) Occurs under conditions of normal peripheral and central nervous system function. (C) Typically responds poorly to opioid analgesics. (D) Typically responds poorly to NSAIDs. (E) Typically responds favorably to adjuvant analgesics.

34.局部麻醉劑主要的作用是經由? (A) sodium channel blocking effect (B) potassium channel blocking effect (C) GABA system (D) NMDA system (E) all of above

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

36.A parturitient of heroin abuse history, asking for painless labor, which one is improper? (A) Meperidine (B) Continuous epidural analgesia (C) Nitrous oxide (D) Butorphanol (E) Intrathecal morphine

37.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

38.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

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

40.就 step-wise approach of chronic pain 的處置流程而言，Pulsed radiofrequency 最早適合於哪一步驟之 前？ (A) Physical therapy (B) Peripheral analgesia (C) Weak opioids (D) Strong opioids (E) Intrathecal opioids

41.有關癌症患者的疼痛治療，下列何者正確？ (A)約有 6~7 成疼痛是來自腫瘤直接侵犯造成 (B) cancer therapy 造成的疼痛很少見 (C) NSAID 是屬於第二線用藥 (D)physical modality 中熱療及電療為絕對禁忌 (E) 為避免 tumor spreading，手術止痛不予採行

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