15. 關於嗎啡類藥物成癮的機轉敘述,下列何者錯誤:
(A)大腦中 ventral tegmental area (VTA)及nucleus accumbens (NA)為最重要影響腦區
(B) 此兩個腦區藉由系統中的mesolimbic pathway 連接
(C)與神經傳遞物血清素(serotonin)的分泌有關
(D) 此中樞神經網路代表了動物行為的「獎懲系統」(reward system)
(E) 與酒精成癮的機制是同一套神經興奮系統

36. 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

37. Which following item is not a criterion for the diagnosis of migraine? (A) Aggravation by or causing avoidance of routine physical activity (B) Unilateral location (C) Moderate or severe pain intensity (D) Throbbing/stabbing quality (E) All are criteria for diagnosis of migraine

38. 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.

39. Which of the following is the acceptable statement about neurodestructive RF lesions? (A) These temperatures are resulted from 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°C (E) All of the above

40. Which one of the following neuropathic pain conditions is not likely responded to spinal cord stimulation? (A) Diabetic neuropathy (B) CRPS type I (C) CRPS type II (D) Central post-stroke pain (E) Occlusive peripheral vascular disease

41. 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.

42. A 52-year-old man complains of a sudden onset of severe, stabbing pain in the left jaw and cheek that subsides in less than a minute. He is pain-free during the intervals between attacks. Activities such as combing his hair and shaving can cause the onset of this facial pain. He is otherwise healthy. The most likely diagnosis is (A) Atypical facial pain (B) Vascular facial pain (C) Postherpetic neuralgia (D) Trigeminal neuralgia

43. A 26-year-old weight lifter felt a sharp pain in the neck, radiating to the dorsal aspect of the forearm during his workout. Over the next few days he noted progressive numbness of the thumb and index finger. He also complained of decreased ability to perform bicep curls. On examination by his primary care doctor, a markedly diminished biceps reflex was found. Which of the following is the most likely cause of the patient's problem? (A) Facture C5 vertebra (B) Facet syndrome at C5-6 (C) C5-C6 disc protrusion (D) Compression of the C5 nerve root by an osteophyte

44. A 61-year-old woman presents to the pain clinic with a chief complaint of left shoulder and arm pain 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 her likely diagnosis? (A) Tumor metastasis (B) Cervical radiculopathy (C) Reflex sympathetic dystrophy (D) Thrombangitis obliterans (E) Radiation-induced plexopathy

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

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