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Bluestone pandant the only right start item for her because of it passive
Bloodforge makes u not squish
Transcendance empovered ur mana and AD proportional
Griffongwing Earrings gives u good AD and Attack speed which u need
The Crusher and Dominance nice finishing for our build
Bluestone Pendant
Bloodforge
Transcendence
Griffonwing Earrings
The Crusher
Dominance
Max Acid spray cause its ur main way to clean waves on line and try hook an enemies with it then if u nice use Lacerate on enemy u can use ur Q and sniped him well. The Main minus of Medusa for such combo its no escape so use it Only with comrades or when u sure yourself absolutely
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Tap each threat level to view Medusa’s threats
Tap each synergy level to view Medusa’s synergies
Medusa is awesome and this is the reason why)
I like Medusa very much like character so I tried to play with her permanently but every time I suck hard and dont understand why, I used a lot of builds but nothing changed so I decided to read her spels and VEW ))) Her AD scalings so much Higher (her ult is 100%) than others ADC have so u must emphasize ur build on it
Every support with stun is perfect for u because of Lacerate that u can use free
The same way hard control ur worst enemy because u can't escape after ur procast
I really sucked all my matches before this build during a long time because i built her wrong hope this one helps u be Better with her))
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I believe Medusa is my most played Hunter. I'll state the things that I've historically preferred, and then propose some adjustments or comments on your build choices, and would like to hear your feedback.
- I've never built Medusa in the meta way. I don't typically prefer full ability, and I don't prefer a full ADC w/ Qin's/AS. I've always liked building her in a hybrid format.
- In almost all previous iterations of my build for her, I've typically gotten
Transcendence. I appreciate not running out of mana while out for extended times, that my abilities are up a bit quicker than if I had no CDR, and that when not fighting, I can use my 1 for additional faster clear (based also on not running out of mana).
- I've always felt crits were great for her. She definitely wants to pick her battles, but the burst you can get from a quick flurry of
Viper Shots + crits is fun, especially when you can easily connect and commit with 
Lacerate as well.
Current meta is sorta bleh.So, some comments about your build:
- Your focus, for the most part, seems to be more on ability damage (Bluestone, Trans, Crusher, Heartseeker). But I feel that if you commit to a lot of ability damage, you probably should look for more CDR than just the 10% you're getting from Trans. Yes, you can still do burst, but in an elongated fight, you're going to be a bit slower to reactivate.
- In this build (and in general), I'm not sold on
Griffonwing Earrings. Yes, it's cheap, and it has both high power and attack speed, but it's generally more of a pure ADC item and it has no pen or other utility. Is it also the passive that you're valuing, or is that just a perk and you are really mainly looking for the power and AS? I'm wondering if you can find an alternative item that gives you similar stats but could help in other ways. While you have 20% overall pen and 30% on basics, could slotting in 
The Executioner (yes it has less power and AS) be considered? Yes it requires stacks for the protection reduction but it could make you significantly more effective against tanks.
- Alternatively, to commit more strongly to ability damage, you could consider replacing Griffon w/ Hydra's or Jotunn's. If you went Jotunn's, that would give you access to a glyph which your build otherwise lacks.
- BF is getting nerfed...again. That said, you might still consider it to be the best lifesteal item for her. That said, I personally would grab Trans first to start the stacking as quickly as possible. If you need an extra potion or two in the early game, I would just do that rather than delay Trans to get BF's lifesteal.
- Well, I'll just state, I think my general preference for her in a standard Conq match would be
Gilded Arrow (Ornate upgrade for the extra crit) -> 
Transcendence -> 
Bloodforge / 
Asi -> 
Demon Blade -> 
The Executioner -> 
Deathbringer. This is definitely a late-game build, with Ornate taking a long time to be full power. But with the 2 other crit items (and avoiding Boomerang), it'll get you high % crit chance. You'll have less immediate damage from abilities without Bluestone / Crusher / Heartseeker, but again, I really like how crit feels on her. Upgrade DB as needed...if you need anti-heal, Envenomed. But you can get some nice CDR if you grab Malicious.
I know that build is quite different than your current preferred, but I would like to know which builds you've tried in the past before you made this build.