97 年 台湾疼痛医学会专科医师考题 --- 笔试部分 (单 .docVIP

97年 台灣疼痛醫學會專科醫師考題 --- 筆試部分 (單選題) 姓名:_____________ 1.下列哪一項是可能是疼痛評估時最重要的參考指標 (A)病人在視覺類比疼痛表 (VAS) 打的分數 (B)癌症病患病情惡化的程度 (C)手術病患傷口的大小 (D)清醒病患自己對疼痛感覺的主訴 (E)嗎啡的使用量 2.病人開胸手術後，接受使用bupivacaine 在硬脊膜外(epidural space) 止痛的病患，手術後恢復期的敘述下列哪一種情形最不正確： (A) 平均加護病房天數比一般病人(控制組)減少 (B) 會增加肺部擴張不全(atelectasis)發生機會 (C) 在呼吸的vital capacity 上僅有些許差異，但在止痛上有顯著差別 (D) 病患下肢深部靜脈栓塞的機會較低 (E) 比一般病人(控制組)在呼吸功能上有顯著改善 3.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 4.一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 5.Neuropathic pain： (A) Occurs only in laboratory animals. (B) Occurs under conditions of normal peripheral and central nervous system function. (C) Typically responds favorably to opioid analgesics. (D)Typically responds favorably to NSAIDs. (E) Often responds favorably to adjuvant analgesics. 6.A disadvantage to using carbamezine is︰ (A)High dependency potential. (B) Hematological side effects. (C) Increased pain. (D)It is not as effective as other drugs. (E) Severity of depression. 7.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. 8.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 9.主導prostaglandin 代謝之COX-1 enzyme存在於? (A) most tissues (B) platelet (C) G.I. tract (D) kidney (E) all of above 10.主導prostaglandin 代謝之COX-2 enzyme存在於? (A) inflammatory cells (B) female reproduction organ (C) brain (D) kidney (E) all of above 11. Which of the following statement concerning “phantom limb pain” is most likely: (A) Phantom pain is the painful sensations referred