Question:

The choice between military products and the provision of healthcare illustrates the problem of 'opportunity cost'. Explain the nature of this problem, using a production possibility curve to help you.

After the second rejection, Bakke filed the instant suit in the Superior Court of California.^[8]He sought mandatory, injunctive, and declaratory relief compelling his admission to the Medical School. He alleged that the Medical School's special admissions program operated to exclude him from the

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*278school on the basis of his race, in violation of his rights under the Equal Protection Clause of the Fourteenth Amendment,^[9]Art. I, 21, of the California Constitution,^[10]and 601 of Title VI of the Civil Rights Act of 1964, 78 Stat. 252, 42 U. S. C. 2000d.^[11]The University cross-complained for a declaration that its special admissions program was lawful. The trial

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*279court found that the special program operated as a racial quota, because minority applicants in the special program were rated only against one another, Record 388, and 16 places in the class of 100 were reserved for them.Id.,at 295-296. Declaring that the University could not take race into account in making admissions decisions, the trial court held the challenged program violative of the Federal Constitution, the State Constitution, and Title VI. The court refused to order Bakke's admission, however, holding that he had failed to carry his burden of proving that he would have been admitted but for the existence of the special program.

Bakke appealed from the portion of the trial court judgment denying him admission, and the University appealed from the decision that its special admissions program was unlawful and the order enjoining it from considering race in the processing of applications. The Supreme Court of California transferred the case directly from the trial court, "because of the importance of the issues involved." 18 Cal. 3d 34, 39, 553 P. 2d 1152, 1156 (1976). The California court accepted the findings of the trial court with respect to the University's program.^[12]Because the special admissions program involved a racial classification, the Supreme Court held itself bound to apply strict scrutiny.Id.,at 49, 553 P. 2d, at 1162-1163. It then turned to the goals the University presented as justifying the special program. Although the court agreed that the goals of integrating the medical profession and increasing the number of physicians willing to serve members of minority groups were compelling state interests,id.,at 53, 553 P. 2d, at 1165, it concluded that the special admissions program was not the least intrusive means of achieving those goals. Without passing on the state constitutional or the federal statutory grounds cited in the trial court's judgment, the California court held

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*280that the Equal Protection Clause of the Fourteenth Amendment required that "no applicant may be rejected because of his race, in favor of another who is less qualified, as measured by standards applied without regard to race."Id.,at 55, 553 P. 2d, at 1166. 10

Question 1

How often should a patient, on 8 mg/day methylprednisolone for the

treatment of rheumatoid arthritis and on osteoporosis prophylaxis in

the form of 1000 mg

Question 2

Can oral folic acid (1 mg/day) be used for high-dose methotrexate

therapy with subsequent leucovorin rescue in the treatment of

rheumatoid arthritis?

Question 3

How often should a patient, on 8 mg/day methylprednisolone for the

treatment of rheumatoid arthritis and on osteoporosis prophylaxis in

the form of 1000 mg calcium and 400 IU vitamin D daily, have a dual

energy X-ray absorptiometry (DXA) scan to detect the development of

osteoporosis?

Question 4

In what percentage of patients with psoriatic arthritis does the arthritis

precede the onset of skin or scalp lesions?

Question 5

1. Is reactive arthritis a synonym for Reiter's syndrome?

2. It is said that Reiter's disease has been related to Chlamydia trachomatis

infection. Is this correct?

Question 6

1. Is the response of an acutely inflamed joint to colchicine

pathognomonic of gouty arthritis?

2. We are told that, other than clinical tests, joint fluid microscopy is

the specific diagnostic test for gout. What does joint fluid microscopy

reveal? Is it the same as a polarized light study revealing needleshaped urate deposits?

Question 7

In the prevention of gout, should allopurinol be used for life in a patient

who is hypertensive, alcoholic and overweight?

Question 8

Does a serum uric acid level of 5.7 mmol/L need treatment? Can it be

significant with cholesterol levels of 213 mg/dL (5.5 mmol/L)? What is

the treatment?

Question 9

In the diet of patients suffering from gout, should tea, coffee or other

compounds containing methylxanthine products be restricted?

Question 10

1. When do joints that appear slightly swollen, but not warm, need to be

tapped?

2. In what circumstances might an immunologically suppressed patient

not mount a fever or not have heat around a septic joint?