fullwidth environment causes trouble across pages. mdframed option too does not work well.
The mdframed answer was suggested by the author for normal text here , How to switch between two margin sizes?
\documentclass[nols,a4paper,twoside,symmetric,justified,marginals=raggedouter]{tufte-book}
\hypersetup{colorlinks} % Comment this line if you don't wish to have colored links
\usepackage{lipsum,mdframed,fontspec}
\definecolor{secnum}{RGB}{13,151,225}
\definecolor{ptcbackground}{RGB}{212,237,252}
\definecolor{ptctitle}{RGB}{0,177,235}
% TOC
\usepackage{titletoc}
\usepackage{etoolbox}
\setcounter{tocdepth}{1}
\pretocmd{\tableofcontents}{\begin{mdframed}[backgroundcolor=ptcbackground,outermargin=\dimexpr-\marginparwidth-\marginparsep\relax,innermargin=0pt,hidealllines=true]\let\cleardoublepage\relax}{}{}
\apptocmd{\tableofcontents}{\end{mdframed}}{}{}
\begin{document}
\tableofcontents
\chapter{Questions of Design}
\section{(title section 1)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\section{(title section 2)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\chapter{Questions of Drawing}
\section{(title section 1)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\section{(title section 2)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\chapter{Questions of Technique}
\section{(title section 1)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\section{(title section 2)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\chapter{Questions of Design}
\section{(title section 1)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\section{(title section 2)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\chapter{Questions of Drawing}
\section{(title section 1)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\section{(title section 2)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\chapter{Questions of Technique}
\section{(title section 1)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\section{(title section 2)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\chapter{Questions of Design}
\section{(title section 1)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\section{(title section 2)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\chapter{Questions of Drawing}
\section{(title section 1)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\section{(title section 2)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\chapter{Questions of Technique}
\section{(title section 1)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\section{(title section 2)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\chapter{Questions of Design}
\section{(title section 1)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\section{(title section 2)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\chapter{Questions of Drawing}
\section{(title section 1)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\section{(title section 2)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\chapter{Questions of Technique}
\section{(title section 1)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\section{(title section 2)}
\subsection{(title sub-section 1)}
\subsection{(title sub-section 2)}
\end{document}

notocto the option list of tufte book. – Marco Daniel Jun 30 '13 at 08:55