For one of my site visits, one of the patients I presented was a 56 year old woman complaining of dizziness and vomiting for the past day.She reported an episode of vomiting the prior morning. Later that night she experienced dizziness and felt that the room was spinning. The dizziness continued into this morning and has since improved. She denies hearing loss, tinnitus, ear pain, fever, chills, night sweats, or any other complaints. One of the first things that came up in our minds on our differential was vertigo, and it came down to trying to distinguish if the cause could be Meniere’s or BPPV. This was a good review of distinguishing between the two conditions. Meniere’s causes vertigo but it is also associated with tinnitus, hearing loss and ear fullness. The patient had denied these symptoms and so we assessed the patient for BPPV. In order to do this, we conducted a Dix- Hallpike maneuver on the patient, in which we turn the head of the patient by 45 degrees and have them lie down quickly in a trendelenburg position in order to observe for nystagmus. The Dix-Hallpike maneuver came out negative for nystagmus. We deduced that considering that the vertigo was improving, that it may have been secondary to her episode of vomiting and we educated the patient on staying hydrated and to stay rested. In order to treat her symptoms we prescribed Meclizine HCl 25 mg 1 tablet as needed. I felt that this was a great example of how we could utilize fairly simple physical exams to rule in and out our differentials and provide the patient with appropriate treatment.  I also learned when it is necessary to treat the disease or to alleviate symptoms, which is something that is very important to know how to distinguish.