4. A disadvantage to using carbamazepine 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.

5. 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) trigeminal neuralgia (B) atypical facial pain (C) postherpetic neuralgia (D) vascular facial pain

6. A patient suffered from chronic low back pain with radiating to buttock, poster lateral thigh and lateral aspect of lower leg. Muscle weakness was observed in the extensor hallucis longus and tibialis anterior. Which lumbosacral root compression is the most likely ? (A) L2 root compression (B) L3 root compression (C) L4 root compression (D) L5 root compression (E) S1 root compression

7. Which neurological signs and symptoms of complex regional pain syndrome (CRPS) among the followings is the highest ? (A) Hyperesthesia/allodynia (B) Coordination deficits (C) Tremor (D) Muscle spasm (E) Paresis

8. 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. 2

9. 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.

10. 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

11. The innervation of deep somatic tissue like muscle and joint is quite complex. Which of the following description is not appropriate? (A) The nociceptors are predominantly activated by non-physiological stimuli which may cause damage to the structures (e.g. overload, twisting, strong pressure, ischemic contraction). (B) During inflammation or after trauma, nociceptors of joint and muscle show pronounced sensitization, in particular for mechanical stimuli. (C) Descending inhibition is enhanced during chronic inflammation but seems to be normalized during acute inflammation. (D) Both primary afferent fibers as well as sympathetic reflexes may aggravate inflammatory lesions. (E) Reduced release of hormones from the hypothalamic-pituitary-adrenal (HPA) axis such as cortisol, adrenal androgens and testosterone may cause a relative loss of anti-inflammatory activity.

12. Which of the following statements concerning the difference between phenol and alcohol when used in neurolytic blocks is/are FALSE?. (A). Phenol takes 15 minutes for neurolysis whereas alcohol's neurolytic effect is immediate. (B) Phenol usually does not produce pain on injection. (C) Intrathecal alcohol is hypobaric, whereas phenol is hyperbaric. (D) Phenol is approximately twice as efficacious as alcohol.

13. When will you make a surgical suggestion as you manage a patient with neck or low back pain? (A) Intractable symptoms for one week (B) No changes in physical findings and no response to conservative management for two weeks (C) Obvious radicular sign without findings of correctable anatomical problem for more than one month (D) No improvement with progressive neurologic deficit in two weeks (E) Mild improvement for more than one month but less than three months

14. For which of the following types of pain are antiepileptic drugs most commonly used? (A) Acute pain (B) Cancer pain (C) Chronic pain syndrome (D) Neuropathic pain (E) Nociceptive pain

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