A cement factory worker presents with chest tightness and wheezing that consistently worsens on Monday mornings and improves by Friday evening. He is asymptomatic on weekends. This pattern is MOST consistent with:
- A Byssinosis (Monday fever pattern) ✓
- B Extrinsic allergic alveolitis (hypersensitivity pneumonitis)
- C Occupational asthma with late-phase reaction
- D Silicosis with superimposed infection
Explanation
Byssinosis in cotton/hemp/flax mill workers classically presents as 'Monday chest tightness' — maximum symptoms at the start of the work week after weekend rest, with progressive improvement as the week progresses (workers 'adjust'). This 'Monday fever' or 'Monday dyspnea' pattern is pathognomonic. Occupational asthma typically worsens on exposure days and improves on weekends (opposite pattern). Extrinsic allergic alveolitis peaks 4–8 hours after exposure and does not follow a day-of-week pattern. Silicosis is progressive and not day-of-week dependent. Note: cement workers can develop occupational asthma, but the classic Monday pattern described is byssinosis.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.