This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Respiratory, Subject name: Medicine
In inhalational anthrax, finding is: 
Select and explain. 
A. Consolidation and pleural effusion, B. Mediastinal widening and pleural effusion, C. Bilateral patchy opacities with pleural effusion, D. None of the above
B: Mediastinal widening and pleural effusion
Answer: B: Mediastinal widening and pleural effusion 
Explanation: Ans: b (mediastinal widening and pleural effusion) Ref: Davidson 20th ed/p.333.This is a direct pick from Davidson.Three forms of infection with Bacillus anthracis:-i) Cutaneous anthrax* Skin lesion due to occupational exposure to anthrax spores or bioterrorism.* Spores inoculated into exposed skin single lesion, an irritated papule on oedematous haemorrhagic base depressed black eschar. Pain infrequent.ii) Gastrointestinal anthrax* Ingestion of contaminated meat products* Caecum is the seat of infection* C/F - nausea, vomiting, anorexia, fever. Later severe abdominal pain and bloody diarrhoea. Toxaemia and death thereafter.iii) Inhalational anthrax* Rare. Associated with bioterrori sm.* Great mortality* C/F - fever, dyspnoea, cough, headache. Later on septicaemia.* CXR- mediastinal widening and pleural effusion.Investigation: Culture from Skin swabs.Management:Ciprofloxacin 500mg daily until penicillin susceptibility confirmed.Benzylpenicillin 600 000units i.m. 6 hourly.Aggressive fluid resuscitation. Ventilatory assistance in inhalational anthrax.Prophylaxis:Ciprofloxacin 500mg 12hourly for high risk from exposure.