IRAC topic (LAW OF TORTS)Peter the Developer Peter is a real estate developer . He develops residential apartment complexes in the Wollongong local area. He purchases a large block of land for $2 million and plans to build a large apartment complex on the block at a considerable profit. But Wollongong Council denies his development application on the basis of a road widening proposal that will substantially reduce the size of the block. This road widening proposal reduces the value of the block of Peter’s land to $1 million. Peter reads the council certificate he obtained from Wollongong Council. If the block of land had been subject to a road widening proposal then it should have been disclosed by Wollongong Council in the certificate. There is no such disclosure in the certificate. As Peter didn’t bother to read the certificate before he purchased the land, he is relieved to find the council has made this mistake. He secretly knows that if Wollongong Council had been careful and included the road widening disclosure in the certificate, he would not have seen it and gone ahead with the land purchase anyway. Peter now wants to sue Wollongong Council in negligence for economic loss. Wollongong Council claims that negligence only applies to physical actions, not written words, and is only applicable to physical damage to people or their property, not economic loss. Advise Peter. 

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Suppose we want to design a new placebo controlled trial to elevate an experimental medication to increase lung capacity. The primary outcome is peak expiratory flow rate , a continuous variable measured in liters per minute . The primary outcome will be measured after 6 months on treatment. The investigators expect to lose 10% of the participants over the course of follow up. The mean peak expiratory flow rate in adults is 300 with a standard deviation of 50. How many subjects should de enrolled to ensure 80% power to detect a difference of 15 liters per minute with a two sided test and []=0.05?

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Ms. S. is a 62-year-old black female who has returned to the clinic to discuss her concerns that her lifestyle modifications to lose weight have not worked. At the last visit 3 months ago, she was advised to change her eating habits and increase activity to promote weight loss. She reports walking at least 30 minutes a day but has lost very little weight. She indicates that the walking only made her extremely thirsty and hungry and attributes her increased thirst and hunger to increased exercise and her increased urination due to drinking more water since “it’s been hot lately” and exercise makes me thirsty”. She has returned to the clinic to discuss if there is anything else that can be done to lose weight and to determine why she is so tired, thirsty and hungry all the time. She also thinks she may have an overactive bladder since she has to urinate frequently during the day, which has influenced her not to go on outings with her friends.

Discussion Questions Part One

Conduct a ROS on this patient.

Indicate which symptoms are most concerning to you.

List your differential diagnoses.

What types of screenings would be appropriate to use based on the chief complaint?

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T.O. is a 44-year-old female patient who presents for evaluation of sudden, severe upper abdominal pain. She is clear about the onset, which was profound and occurred approximately one hour ago. She denies that the onset had any relationship to food or eating, and she denies nausea or vomiting. On examination, she is lying on her right side with her hips and knees flexed to draw her knees to her chest. Vital signs are stable, but examination reveals involuntary guarding. The abdomen is painful and tympanic to percussion in all quadrants. CBC reveals a white blood cell count of 15,600/uL. The AGACNP suspects:

A. Dissecting aortic aneurysm

B. Acute pancreatitis

C. Perforated peptic ulcer

D. Mallory-Weiss tear

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