START OF GAME

For your crest, you can either go Fenix or Iceskorn Talons. Personally I would usually pick Fenix so I can stay in the fight a lot longer or even survive longer in general when I'm low. Your main primary items you need to build first are always, OVERLORD, BASILISK, and CITADEL. Overlord first because it should help with clearing your camps more efficiently as well as gaining a lot of health. Every time you build a health item, you get more power. Your second item should always be Basilisk. The item gives you a lot of health as well a lot of haste. This item also shreds armor and effectively deals damage. Last but not least, Citadel. This is your main defensive item that gives you a good amount of physical armor, power as well as health. This should be a niche within your build because of Khaimera's very aggressive playstyle. This also goes well with Basilisk because it reduces their physical armor while you gain physical armor. After building those three main items, You should be around mid to late game. The last two items are situational to go against the other teams composition.

SITUATIONAL ITEMS FOR MID-LATE GAME

If your going up against a lot of CC and keep getting stunned or immobilized (Steel, Sevarog, Grux, Rampage, Phase, etc)
- Unbroken Will

If your going up against a burst hero who can deal a lot of damage within a short second
- Stonewall (You can just punish them for doing a lot of damage like Serath for example.)

If your going up against a powerful carry and want to deal with their critical strikes (Drongo, Kira, Murdock, etc)
- Warden's Faith

If your going up against a team that uses a lot of magical damage for most of their fights (Gideon, Belica, etc)
- Crystalline Cuirass

And if your really ahead against the enemy team as well as nothing to worry about
- Berserker's axe or Giant's ring