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Do your best to kill her lvl 1, if not possible then make her use her potions as early as possible. Once she hits lvl 6, you should be dead. Ask for jungler's help and farm as much as possible.
Anivia
You straight up win early game, as long as you hit abilities and dodge her Q. You should be able to kill her. After 6, it becomes hard to match her wave clear speed, but you shouldn't die to her.
Annie
You should kill her early on, or at least make her laning a hell. She has low range abilities, no dashes or blinks, and poking should be easy. At 6 you should exhaust and outdamage (assuming you have a small lead on her), at worst you go 1 for 1.
Ekko
Not an impossbile matchup, but for sure the most annoying one, for me at least. It's hard to hit abilities on Ekko, but do your best to gain an advantage on him lvl 1 or 2. Ekko becomes unkillable for Karthus later on if you fail to get an advantage, and he will farm you. Ask for jungler ganks/pressure.
Fizz
Do your best early game not to let him be even farm/exp with you. Try to make him go base as many times as possible before 6. At 6, you can exhaust one all in and escape, but next times you are dead. Hitting abilities on Fizz is also hard. Ask for jungler ganks.
Heimerdinger
You should beat him. Kill his turrets and don't let yourself be hit by his stun. Ask for ganks since he is very vulnerable, and easy to kill in a 2v1. After 6 it becomes a bit harder, just make him to waste his ult and you'll be fine.
Kassadin
Early game is yours. You can poke him well and even kill him at lvl 1/2, if he overstepps. Once he gets 6, this lane changes drastically if you couldn't get any sort of advantage - he can no longer be killed by Karthus in a 1v1 unless he is just that bad. The longer the game goes, you will get easily farmed by him if you don't get any help. Ask for ganks and make sure you don't let him scale into the monster that he is.
Katarina
She is very mobile, has no mana costs, and deals a lot of dmg in a short time. You can't really do much here, unless you somehow manage to poke her. Try to farm as much as possible, know your place and ask for jungler help.
LeBlanc
This matchup is disgusting. Straight up, you will eventually get killed over and over again if you overstep even a bit. Your legit change to gain an advantage is outplaying her at lvl 1. Ask for ganks and farm as much as you can.
Lux
You kill her. That's it. Don't get hit by her Qs, and you are good to go. All in and spam Qs, she will die quickly.
Orianna
Not easy, not hard. Just be aware of her range, and don't underestimate Phase Rush. You can trade with her decently early lvls, if you isolate her you could probably force her flash. As the game advances, it becomes harder and harder to approach her since you both have similar range for the main ability - Q (875 yours, 825 hers). You have much more raw dmg, but she has more utility for her team.
Syndra
Syndra consumes a lot of mana early game, so just make sure to dodge a few Qs and early game is yours. Force fights once she misses E. Be aware of her kill potential at 6, and also pay attention to her balls' position as she can stun you from far away with their help.
Xerath
He outranges you. Straight up, you shouldn't win against a good Xerath. Don't get hit by every Q he throws (don't be in the same place as your minions - make him choose what he wants to hit), try to bait his E and you can all in him. Early game he doesn't have the mana needed to poke a lot/kill you, so try your best to force fights once you dodged his E. Don't let him poke without being afraid of you. He has no escapes, and your W slows a lot, so just ask for a gank.
Malzahar
This should be an easy lane for you. At lvl 6, he won't kill you by himself (unless you play poorly), but it brings a huge pressure considering his jungler can come at any time and kill you.
Sylas
Poke him early game, and bait him into getting closer to you. You should win the all in, assuming you don't get hit by everything he throws at you. Very killable, if you play properly.
Ziggs
Very annoying. He has strong and easy to use disengages. He outranges you. He'll poke you easily. Your best bet is trying to bait his defensive abilities and then go in. If he isn't stupid, just farm. Don't die and ask for help. Early game, you have a lot of chances to actually be relevant in this lane. As more minutes go by, he gets items and eventually one Q will hit for half of your HP.
Vladimir
It mostly depends on how good you can play the early game. He is vulnerable since he has long cooldownds and has no relevant dmg/healing until he gets some items. Try to get the most out of his early game. Once he gets 6 and items, he can eventually beat you and escape.
Twisted Fate
Don't be hit by his Qs, they are easy to dodge. You can and should kill him as early as you can. The longer the games goes, it will be much harder as he has a lot of movement speed and kiting potential.
Veigar
Veigar is literally useless early game. Very easy to kill him early on, especially at lvl 1. Once he has his stun, try to bait it and don't get caught as he can set up ganks easily with it. Ask for ganks to farm him, until he becomes very hard to deal with. In the later stages of the game, you won't be able to kill him anymore - and you will get one-shot.
Yasuo
Let's be real, it's hard for you to hit abilities on a champion that dashes permanently. Test the yasuo player to see if he actually knows what he's doing or no, you can all in and kill him if he underestimates you early on. You probably focus on not dying and farming as much as possible. It's easier for you to be useful after lane's over.
Yone
Lvl 1 is definitely much easier than vs Yasuo, and you should try your best here to either make him use his postion/back. But, unlike yasuo, once he gets some lvls/items going it won't be possible to kill him (considering you are at even items) in 1v1. Ask for ganks, stay alive, farm.
Zoe
Be agressive early game. Don't get hit by her E. That's it, and you kill her. In the later stages of the gamer, that will be no longer possible - you will get sniped and die easily.
Jax
Play properly early game - pay attention to his stun's range and how many stacks he has on the passive. Jax has very long cooldowns, you can abuse him very well early game. Don't expect to keep winning once this guy has Botrk or Trinity, or any completed item, really - if you didn't get any advantage and just farmed equally. Your exhaust helps a lot with his engages and you can bait him with it.
Hecarim
You can't do much vs Hecarim in jungle, he just runs you over (literally). Don't pick Karthus vs Hecarim, and just dodge if he picked after you.
Evelynn
Not impossible to win the game vs Evelyn, but definitely disgusting to play against. She can kill you easily after 6, without dying. You should dodge the game if you can, play it if you can keep your positive mental attitude. :)
Kayn
It's hard to play against a good kayn, really. If he goes assasin, you get one shot. If he goes red kayn, you will never kill him. I'd dodge. If you believe he won't be that good, or that you are the better jungler, go ahead and play the game. It's not impossible to win the game, just too annoying and it may not be worth playing.
Irelia
Hard. You must dodge her E's. You don't dodge, you die. Pay attention to her passive, you definitely don't want to fight against her fully stacked passive. Ask for jungler help.
Zed
Do your best before he hits 6. At 6, you die without exhaust up. It's up to you to determine if he knows what he's doing or not. Very easy to kill bad Zed players, almost impossbile to kill someone that can play the champion properly. Most people can't play Zed, so you still have chances to win by being the better player - but the matchup is in his favor. Farm, stay alive.
Talon
Early game shouldn't be that hard to deal with, you may even win. But can you (and your team, obviously) deal with his roaming? A bad Talon would just sit on mid trying to kill you 1v1, but a good one will try 24/7 to find kills on the map. You can't outroam him, or even follow. It's a gamble that you make if you don't dodge.
Soraka
Global Heal vs Global Damage. Definitely very annoying, she can deny you many kills midgame. Once you have more items, her heal can't match your dmg.
Caitlyn
She won't really kill you (it depends on the support, tho), but her range and E make her too safe for you to kill or even poke.
Ahri
It's hard to lose early game vs Ahri. You must punish her early game as much as possible, as for ganks as she has no escape pre 6 => easy kill. Once she's 6, she starts to be relevant, but not yet to the point she can kill you in a 1v1 - but be cautious as now that she can dash into you that creates more pressure for her jungler. You will die to any gank when she has ult up, considering how easy is to hit her charm when she just dashes right next to you. Later on, it becomes hard to win vs her 1v1.
Aatrox
He shouldn't be a problem for you toplane, as long as you keep distance. Poke as much as you can, try to even get a kill at lvl 1 if he's stupid.
Alistar
On botlane, either as Karthus bot/supp, he is pretty weak. Sure, you are imobile and he has hard CC. But most Alistar players will throw you away from them, so often missing combos on a champ with very high cooldowns... meaning he stays useless for longer than he can be useful. You can either poke him out early on or completly ignore and go for the enemy AD.
Amumu
Amumu wants to farm. You want to farm. You are the better champion.
Ashe
Long range poking, that's kinda what makes Karthus hard to play on botlane. She has no escapes, so if you can all in (it depends on supports, if you are Bot) do it. You outdamage her early on, and all game long.
Aurelion Sol
He is annoying to deal with, try to keep up with the waves. You can't let him roam freerly, match his push as much as you can. Ping laners he's missing, and keep farming to get gold/exp while he's missing. At the end of the day, your champion is simply better, but you gotta let your teammates know when he's gone. Don't try to follow, in most cases you waste time.
Azir
Early game, you can pretty much poke better. As the game goes on, he becomes very hard to deal with, especially because of his ultimate and long dashes.
Bard
An easy kill. Pay attention to his passive and also positionate well against his Q.
Blitzcrank
Same old story with blitz, you dodge his Q, and he is beyond useless.
Brand
He's very squishy, be sure to dodge any combo that stuns you and you are good to go. Not that hard to kill.
Draven
I'm biased. I have met very terrible Draven players, in all elos I've ever played, rarely a good Draven was to be seen. Thing is, I feel like this matchup can easily go in Draven's favor, but it just doesn't happen often when I play vs him. Q where his Qs land, all in with exhaust. You can provoke them easily, they will lose focus and start being frustrated quickly.
Illaoi
Not that hard of a matchup, especially early game. You must take advantage of your dmg, try your best to kill her lvl 1, or make her B/use all pots. Very easy gankable, ask your jungle to come top and get the free kill.
Soraka
Global dmg + Global healing in the same team. Not much to say.
Synergies
IdealStrongOkLowNone
Soraka
Global dmg + Global healing in the same team. Not much to say.
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