Reporting to Ralph about either the Ducal murderer (Cybu) or exposing Elrath will break the escort quest (the healers move on their own, and if the two soldiers weren't healed by then, those quests are also broken). You miss a level of Restoration, +2 Reputation and some experience by not healing the patients. The lizard scroll is only needed for one teleporter pad, in and area you will have little need to return to once cleared.
The Marcus/Tingalf/wagon quest can also be partially screwed up by doing things too much out of expected order, but even then you should get the reward and most of the experience.
If you agree to burn a cart in Verdistis, you must do so that day.
Though many of the problems mentioned are fixed in the latest
patch, see also;
QUESTBREAKERS AND MAKING DIV LIFE DIFFICULT (Spoilers)
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