How can you identify otitis media during an examination?

Identifying otitis media during an examination can be effectively done by observing a bulging tympanic membrane. This bulging occurs when fluid accumulates behind the eardrum, which is a hallmark sign of otitis media. The pressure from the fluid can cause the membrane to bulge outward, which is visible during an otoscopic examination. The presence of redness and diminished landmarks on the tympanic membrane may also accompany this finding, providing further evidence of inflammation or infection in the middle ear.

The other options do not indicate otitis media. A clear ear canal suggests that there is no blockage or wax buildup, which does not relate to a middle ear infection. A normal hearing test indicates healthy function of the auditory system, which would likely not be the case in a patient with otitis media, as hearing loss can occur due to the fluid affecting sound transmission. Lastly, dry cerumen buildup refers to earwax accumulation in the ear canal, which is unrelated to the presence of fluid in the middle ear and thus does not provide evidence of otitis media.