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This is my favorite way to play Karma. Not gonna claim it's the best or it's even good. This is my first build and I really don't know how to make one lol. But here goes.
Ok there are different ways to go with the runes. Always magic pen reds. Yellows I personally use mp5 per lvl just because it helps scale into late game. You can use flat if you like for early game boost. For blue I use flat CDR even though as the game goes you will max CDR in items. I just feel it helps farming in the beginning. But if you want you can throw in flat ap for a good boost. For quints I use flat AP to help start me out. More heals and more shield. If you don't like that you can really put whatever feels good for you. I just suggest flat ap for a good start.
I start with a dorans ring because it really fills everything karma needs. Next I go for CDR boots because it's important to get max CDR fast on her. More CDR = more heals and better farming with her shield. After I finish the boots I head to Morellos tome. Great item for Karma. Gives her MP5 to spam spells and also more CDR and ap. I just find the item too good to not get. Now your CDR is maxed. Let the spamming of mantra begin. After I build my tome I try to lane long enough for my Needlessly Large Rod. A lot of ap for the bigger shielding and healing. After that is complete I complete my Rabadons Deathcap. That is the core build. After the core is complete i'll either head to Zhonyas Hourglass if there is a lot of physical dmg. If they have more ap than physical I will get an Abysal Scepter. Great item also, gives the aura for the team and gives you more defense. Most likely they will target you because they wont be able to kill anyone lol. So if you get Hourglass first I would get Abysal next and the other way around. From there on out it is your choice of what to get. Do you need more defense? Or are you dominating and can get more ap. Personally I stack ap just because the more ap you have the bigger heal and more defense you have anyways with the shield. Plus more ap helps with Rabadons.
I personally use Teleport and Clarity because it is great for support to be able to spam spells. How does it feel letting a team mate die because you didn't have enough mana for a shield or a heal. It sucks. So i recommend Clarity for sure. Teleport because I don't like wasting time running back. I would rather get back fast and continue farming. But if you do not like them Flash or ghost is good for survivability. But honestly with my shield and heal I don't need them.