16. Which drug below is less likely an option for inhibiting central sensitization following acute postoperative pain:
(A) NMDA antagonist
(B) Opioid
(C) COX2-inhibitor
(D) Pre-emptive analgesia
(E) Gabapentin

17. Which postoperative factor may not delay recovery: (A) Pain (B) Nausea and vomiting (C) Ileus (D) Hypothermia (E) Optimal mobilization 

18. 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

19. Correct comparisons between osteoarthritis (OA) and rheumatoid arthritis (RA) dose not include: (A) Steroids and the newer drugs that focus on controlling cytokines, such as tumor necrosis factor (TNF), may reduce pain in OA and RA (B) OA mainly involve the joints and RA may present extra-articular features (C) OA appears to be a mechanically driven, and RA presents an immunologically driven disorder (D) Pain management is similar in RA and OA, but the main focus is on controlling the disease process through the use of disease-modifying antirheumatic drugs (DMARDs) (E) Female sex is a common factor in either OA or RA

20. Which medication below is not suggested in fibromyalgia syndrome (FMS): (A) Non-steroidal anti-inflammatory drugs (ibuprofen, naproxen) (B) Pregabalin (C) Tricyclics (amitriptyline, nortriptyline, doxepin, cyclobenzaprine) (D) Opioids (E) All of the above treatments are suggested for pain management of OA

21. 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 

22. Piriformis syndrome 是由於梨狀肌(piriform muscle)壓迫那一條神經所導致? (A) 股神經 (femoral nerve) (B) 坐骨神經 (sciatic nerve) (C) 股外側皮神經 (lateral femoral cutaneous nerve) (D) 腓總神經 (common peroneal nerve)

23. 根據 American College of Rheumatology 的定義，在其挑定全身的 18 處解剖區域中若有幾 處痛點即可診斷為 Fibromyalgia Syndrome： (A) 7 (B) 9 (C) 11 (D) 13 (E) 15

24. 下列何者不具有 Na channel blocker 的作用： (A) Amitriptyline (B) Carbamazepine (Tegretol) (C) Lidocaine (D) Gabapentin (Neurontin) (E) Mexiletine (Mexitil)

25. 下列有關 Complex regional pain syndrome(CRPS)之敘述，何者最不正確？ (A) 依發生率及盛行率而言，CRPS typeⅠ比 typeⅡ多 (B) 估計骨折後進展成為 CRPS typeⅠ之發生率 1-2％ (C) 估計因周邊神經損傷後進展成為 CRPS typeⅡ之發生率平均約 4％ (D) 女比男之發生率約為 1: 2 到 1: 4 之間 (男比女多) (E) 交感神經阻斷術可做為診斷及治療的方式

26. 一位 45 歲男性椎間盤突出，引起頸部、肩甲骨內側、前胸上臂及前臂內側疼痛，伴隨有前臂尺側部位麻木，以及眼瞼下垂。請問最有可能壓迫到之神經根位置為？ (A) C5 root (C4-5 disc) (B) C6 root (C5-6 disc) (C) C7 root (C6-7 disc) (D) C8 root (C7-T1disc) (E) T1 root (T1-2 disc) 

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