17. Which opioid described below belong to ―full agonist‖?
(A) buprenorphine
(B) fentanyl
(C) nalbuphine
(D) butorphanol
(E) naltrexone

18. Pain is a frequent consequence of spinal cord injury (SCI). Which of the following statement is least likely: (A) Below-level neuropathic pain is most likely described as severe or excruciating months or years following initial injury. (B) Damage to the spinothalamic tracts is an important ingredient in the development of neuropathic pain following SCI. (C) Chronic musculoskeletal pain is common in tetraplegic patients after SCI. (D) Patients with cervical SCI are at risk of developing CRPS affecting upper limbs. (E) Below-level neuropathic pain is also referred to deafferentation pain.

19. About diagnostic nerve blocks, which one of following statements is wrong? (A) May help in locating the origin of pain. (B) Pain originating from malfunctioning CNS pain modulation may also be relieved by a peripheral nerve block. (C) Repeated diagnostic blocks are mandatory before any attempted chemical or physical denervation. (D) Are reliable as prognostic aids for neurolytic procedures. (E) Pain relief from a saline block does not indicate a psychogenic pain or malingered pain.

20. Choice a right description about acute pain associated with chemotherapy toxicity. (A) Intraperitoneal chemotherapy seldom induces abdominal pain. (B) Vincristine treatment can induce peripheral neuropathy. (C) ntrathecal methotrexate produces an acute menigitic syndrome in 80% of patients (D) 5-fluorouracil (5-FU) produces peripheral neuropathy but no chest pain. (E) None of above is right.

21. About the failed back surgery syndrome (FBSS), which one of the following procedure may be the last to be considered due to possible poor response? (A) caudal steroids injection (B) epidural adhesive lysis (C) spinal cord stimulation (D) radiofrequency denervation (E) lumbar sympathetic block

22. Effects on postoperative morbidity of regional anaesthetic or analgesic techniques compared with those of general anaesthesia and systemic postoperative analgesics may reduce the following complications, except: (A) pulmonary embloism (B) myocardial complications (C) pulmonary infectious complications (D) cerebral complications (E) other thromboembloic complications

23. Which of the following statement concerning painful polyneuropathies with prevalent loss of small fibres is most likely: (A) Chronic renal failure neuropathy. (B) Diabetes mellitus neuropathy. (C) Alcoholic neuropathy. (D) Myeloma neuropathy. (E) soniazid neuropathy.

24. About chemical neurolytic nerve blocks, which one of following statements is wrong? (A) Phenol or ethanol is usually used for chemical denervation. (B) The duration of these blocks is often disappointingly brief. (C) They may induce deafferentation-neuropathic type pain. (D) They are often indicated for patients with chronic pain and a normal life expectancy. (E) They can be used in patients with advanced cancer disease.

25. Choice a right description about treatment of cancer pain. (A) Because of the complexity of cancer pain, 3 analgesic ladder from WHO was not useful. (B) Surgery, Chemotherapy and radiotherapy are not the analgesic titration for cancer pain. (C) Only 10-20% of patients ultimately require regular strong opioids. (D) Constipation is common for opioid use, but laxative can be used only when symptom exists. (E) None of above is right

26. 有關 hyperalgesia 的描述何者為非？ (A) 組織受傷會導致許多促進發炎反應的化學物質的釋放，包括 bradykinin，prostaglandins， leukotrienes，serotonin，histamine，substance P，thromboxanes，platelet-activating factor， adenosine，ATP， protons 以及 free radicals 等等 (B) Hyperalgesia 不僅發生在受傷的區域，也會發生在周圍未受傷的區域 (C) 在周圍未受傷害的區域產生的 hyperalgesia 稱之為 primary hyperalgesia. (D) 在發炎反應的時候，marcopharges 會釋放 cytokines 來調節發炎反應。 (E) 促進發炎反應之因子，如 cytokine 會促進神經生長因子之產生，再直接或間接地加強疼 痛現象。

27. 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) Lateral femoral cutaneous nerve block (D) Illioinguinal nerve block (E) Lumbar sympathetic block

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