Neuro: craniopharyngioma field defect: practice question

A Ophthalmology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Ophthalmology · Neuro: craniopharyngioma field defect

Sample item

A child with a suprasellar calcified cystic mass compressing the chiasm from above will first show which field defect?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Inferior bitemporal quadrantanopia

Craniopharyngiomas compress the chiasm from above, damaging the superior crossing fibres of the inferior retina first, so inferior bitemporal defects appear. Pituitary adenomas push from below, giving superior bitemporal defects first. Calcification is typical on imaging.

Option by option

  • A. Binasal hemianopia

    Binasal defects occur with lateral chiasmal compression.

  • B. Central scotoma

    A central scotoma indicates macular or optic nerve disease.

  • C. Superior bitemporal quadrantanopia

    A superior bitemporal defect is from a mass below the chiasm.

  • D. Inferior bitemporal quadrantanopia (correct)

    Correct. Compression from above gives inferior bitemporal defects.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Ophthalmology question

What is the answer to this Ophthalmology question?

The best answer is D, Inferior bitemporal quadrantanopia. Craniopharyngiomas compress the chiasm from above, damaging the superior crossing fibres of the inferior retina first, so inferior bitemporal defects appear.

Why is "Binasal hemianopia" not the answer?

Binasal defects occur with lateral chiasmal compression.

Why is "Central scotoma" not the answer?

A central scotoma indicates macular or optic nerve disease.

Why is "Superior bitemporal quadrantanopia" not the answer?

A superior bitemporal defect is from a mass below the chiasm.

What concept does this question test?

It tests Neuro: craniopharyngioma field defect in Ophthalmology. Pituitary adenomas push from below, giving superior bitemporal defects first. Calcification is typical on imaging.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neuro: craniopharyngioma field defect?

Group the red eye by what to examine and what the pupil does. Then use the flashcards and the other Ophthalmology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.