SWAT4.
There are no power-ups, no ammunition or weapons to pick up, no medikits either. You start out each mission with whatever you equip youself with and that's it. If you want the gas mask, you need to forego the armored helmet. If you use the heavy body armor, your mobility is impaired.
If you get hit in an arm, your aiming falters; if you get shot in the leg, you limp and can no longer run. A well-placed shot (not necessarily a headshot) will kill you.
The game strives to be as realistic as possible which normally is a sure-fire formula for designing a bad game but with SWAT4 the formula works incredibly well.