the 645D will be / is: bigger, heavier, much more expensive than the K7. You'll need 645 lenses, as the 35mm K mount ones are too small and won't mount or work.
Med format is thought of as more meticulous etc - but this is in part due to the fact that you get fewer shots per roll of film... and the larger film area entails a different learning curve for DOF etc. As the Pentax cameras don't have tilt/shift etc, otherwise, the shooting is straightforward, and with digital, you can go just as crazy as you can with an APS-c camera