American Board of Internal Medicine (ABIM) Certification Practice Exam

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Under what circumstances is treatment for cerumen impaction indicated?

If there is any ear wax present
In symptomatic patients or when the tympanic membrane needs to be visualized
Only in elderly patients
When hearing loss occurs

The correct answer is: In symptomatic patients or when the tympanic membrane needs to be visualized

Treatment for cerumen impaction is indicated in symptomatic patients or when the tympanic membrane needs to be visualized because the presence of ear wax does not always require intervention. Symptoms such as hearing loss, earache, dizziness, or itching may prompt treatment to relieve discomfort and restore ear function. Additionally, if a healthcare provider needs to examine the tympanic membrane—perhaps to rule out other causes of ear-related symptoms—clearing the ear canal of excessive wax is essential. In contrast, just having ear wax present does not automatically necessitate treatment, as it is normal for cerumen to be produced. Focusing solely on elderly patients overlooks the fact that cerumen impaction can occur in individuals of any age. Hearing loss may be a sign of impaction, but it's the presence of symptoms or the need for examination of the tympanic membrane that specifically dictates the urgency for treatment.