Visual pathway: pituitary adenoma: 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 · Visual pathway: pituitary adenoma

Sample item

A pituitary macroadenoma compressing the chiasm from below first affects which part of the field?

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

The answer and the reasoning

C. Upper temporal quadrants

A lesion pressing from below compresses the inferior chiasmal fibres, which represent the superior temporal fields, so upper temporal quadrantanopia appears first. Craniopharyngioma compresses from above and gives a lower temporal defect first.

Option by option

  • A. Central field

    Central field involvement occurs later with prechiasmal compression.

  • B. Upper nasal quadrants

    Nasal fields are not affected first.

  • C. Upper temporal quadrants (correct)

    Correct. Inferior compression gives superior temporal loss first.

  • D. Lower temporal quadrants

    Lower temporal defects come first with suprasellar lesions.

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 C, Upper temporal quadrants. A lesion pressing from below compresses the inferior chiasmal fibres, which represent the superior temporal fields, so upper temporal quadrantanopia appears first.

Why is "Central field" not the answer?

Central field involvement occurs later with prechiasmal compression.

Why is "Upper nasal quadrants" not the answer?

Nasal fields are not affected first.

Why is "Lower temporal quadrants" not the answer?

Lower temporal defects come first with suprasellar lesions.

What concept does this question test?

It tests Visual pathway: pituitary adenoma in Ophthalmology. Craniopharyngioma compresses from above and gives a lower temporal defect first.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Visual pathway: pituitary adenoma?

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.