I’d recommend playing on hard or very hard to make your skills matter. I was disappointed at how easy it was to kill pretty much anything with my “diplomat” build (no weapon skill increase). Once you get a “real” (non-robotic) companion combat become trivial, save a couple areas and a few encounters.

Karma has little to no impact on the game. I’ve seen one guy refuse to give me a quest for being a goody two shoes, but I could acquire the quest anyway with a speech check. There was one [Karma] dialogue option at the end of the game, but also accompanied by a speech check saying basically the same thing.

Faction reputation is much more important as killing a few members of one easily gets you to Vilified status, which is almost impossible to recover from. That may cut you from a few quest lines and prevent getting any ending but the “completely wiped out” and “left alone” ones. Be careful who you side with and try to meet each party before you commit to a direct assault.

As far as bugs go, they’re not so bad. Nothing game breaking as long as you let Steam in offline mode. The often stupid AI and the many intrusive scripts were much more of an issue for me.

One thing I can only recommend is the invisible wall removal mod. Look it up and save yourself some frustration later ;)