An explanation that includes three of the following points:
- (change in structure of haemoglobin) haemoglobin \{binds / carries\} less oxygen (1)
- (shape of red blood cell) smaller surface area so less oxygen diffuses in / red blood cells get lodged in blood vessels preventing flow of blood to cells (1)
- therefore less oxygen to \{cells / tissues\} so \{less available for (aerobic) respiration / switch to anaerobic respiration (1)
- credit an example of why less oxygen to cells could be fatal (1)
NB accept converse where appropriate
ACCEPT named cell / tissue
e.g. heart attack, stroke, sepsis, infection
(3)