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

42.癌症病人，因病灶刺激橫膈膜，何部位會有 referred pain？ (A)肩胛骨中間 (B)肩膀 (C)耳朵 (D) 鼠蹊部 (E) 膝關節

43.以下有關於癌症病人疼痛治療的敘述，何者正確？ (A)應優先使用注射方式給藥 (B) 應優先使用非鴉片類止痛藥 (C) 應優先使用短效藥物 (D)物理治療通常對急性疼痛無效 (E) 應單獨使用鴉片類藥物，不需和其他藥物併用

44.下列何種慢性疼痛病患接受 spinal cord stimulation 的治療效果最好？ (A)refractory angina pectoris (B) complex regional pain syndromes (C) phantom pain (D) postherpetic neuralgia (E) complete nerve root avulsion

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