Neutropenia: Neutropenia is an abnormally low number of neutrophils  
Causes

-Typhoid, paratyphoid. .
-Viral and ricketseal infections.
-Malaria, Kala azar.
-Hypersplenism.
-Aplastic and megaloblastic anaemia.
-Marrow infiltration by malignancies, lymphomas etc.
-SLE.

Verruca vulgaris
1. Commonly known as warts.
2. Caused by the human papillomavirus (HPV).
3. Warts can be seen on skin or as an oral lesion (vermilion border, oral mucosa, or tongue).
4. Transmitted by contact or autoinoculation.
5. A benign lesion.

Congenital heart defect
Congenital heart defects can be broadly categorised into two groups,
o    acyanotic heart defects ('pink' babies) :

 An acyanotic heart defect is any heart defect of a group of structural congenital heart defects,  approximately 75% of all congenital heart defects.
 It can be subdivided into two groups depending on whether there is shunting of the blood from the left vasculature to the right (left to right shunt) or no shunting at all.

Left to right shunting heart defects include 
- ventricular septal defect or VSD (30% of all congenital heart defects),
- persistent ductus arteriosus or PDA, 
- atrial septal defect or ASD, 
- atrioventricular septal defect or AVSD.

Acyanotic heart defects without shunting include 
- pulmonary stenosis, a narrowing of the pulmonary valve, 
- aortic stenosis 
- coarctation of the aorta.

cyanotic heart defects ('blue' babies). 
obstructive heart defects

 cyanotic heart defect is a group-type of congenital heart defect. These defects account for about 25% of all congenital heart defects. The patient appears blue, or cyanotic, due to deoxygenated blood in the systemic circulation. This occurs due to either a right to left or a bidirectional shunt, allowing significant proportions of the blood to bypass the pulmonary vascular bed; or lack of normal shunting, preventing oxygenated blood from exiting the cardiac-pulmonary system (as with transposition of the great arteries).

Defects in this group include 
hypoplastic left heart syndrome,
tetralogy of Fallot, 
transposition of the great arteries, 
tricuspid atresia, 
pulmonary atresia, 
persistent truncus arteriosus.
 

General chromosome abnormalities
The normal human cell contains 46 chromosomes, including 22 homologous pairs of autosomes and one pair of sex chromosomes (XX for female and XY for male). A somatic cell is diploid, containing 46 chromosomes. Gametes are haploid, containing 23 chromosomes.
Aneuploidy
(a) Any deviation in the number of chromosomes, whether fewer or more, from the normal haploid number of chromosomes.
(b) Nondisjunction—a common cause of aneuploidy. It is the failure of chromosomes to pass to separate cells during meiotic or mitotic cell division.
(c) Often seen in malignant tumors.
 

Deletion: loss of a sequence of DNA from a chromosome.
 

Translocation: the separation of a chromosome and the attachment of the area of separation to another chromosome.

Agranulocytosis. Severe neutropenia with symptoms of infective lesions.

Drugs. are an important cause and the effect may be due to .
-Direct toxic effect.
-Hypersensitivity.

Some of the 'high risk drugs are.
-Amidopyrine.
-Antithyroid drugs.
-Chlorpromazine, mapazine.
-Antimetabolites and other drugs causing pancytopenia.

Bloodpicture:  Neutropenia with toxic granules in neutrophils. Marrow shows decrease in granulocyte precursors with toxic granules in them.

Autoimmune(acquired) Haemolytic anaemia

Auto antibodies are usually Ig g type (may be Ig M or Ig A). They may or may not bind complement and may be active in warm or cold temperature  They may be complete (agggIutinating) or incomplete. Haemolysis s may be intravascular  due to destruction of the antibody coated cells by RE system.

Causes:

a. Idiopathic
b. Secondary to
o    Drugs - Methyldopa, Mefanamic acid

o    Disease like
    -> Infections especially viral.
    -> Autoimmune disease especially SLE.
    -> Lymphomas and chronic  lymphatic leukaemia.
    -> Tumours.
    
Diagnosis : is based on

•    Evidences of haemolytic  anaemia.
•    Demonstration of antibodies

    - On red cell surface by direct Coomb’s test
    - In serum by indirect Coomb’s test.