On Normal accounts, you have an extremely generous amount of items that you can exchange for PKP points. Items ranging from the standard teleports all the way to Peg boots.
On realism, you get the most basic items in the PKP shops. Maybe because it has a seperate ECO or so but I think adding a few more of these items into the PKP store for realism wouldnt be such a bad idea. Even if it cost more PKP to get certain items than it does on Normal accounts!