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I'm top 5%, Law Review at T-14 but only got a V50 where I don't really like the culture. I'm obviously going to go there this summer but to move up, would doing a federal clerkship and then re-entering the market work, or will I likely just end up with the same firm? Also, I want to do transactional work so would a clerkship help either in getting a better firm or lateraling in my career later?

most clerkships won't help with transactional (though DE Chancery, some others arguably might). You could try 3L OCI, since it's mostly for trying to trade firms. Or just be thankful you got an offer with whatever defect in your application made top 5% do so poorly, and just try and make the best of the summer. maybe you'll like it more than you think.

Go 3L OCI. At my T14 there were lots of 3Ls this year with firm offers who were looking to move to better firms, and many of them did just that.

From what I gather, 3L OCI is only a joke if you're looking to break into biglaw (either because you didn't get an SA position or, worse, were no-offered). But if you have an offer in hand, you can usually leverage up.

At my school (T14), I know of two students who were around top quarter, only got lower V100 firms, and then landed V10 firms from interviewing after their 2L summers. This fall several top firms were hiring 3Ls (usually just for transactional), even though most didn't advertise through the school. Assuming you get an offer, you'll be in an excellent spot to trade up as a 3L. I also know someone else with much lower grades who got several DE Chancery interviews--clerking there and then seeking to trade up would also work. Don't think you're stuck at the V50 just because that's all you got from 2L OCI. But keep your grades up, and much more importantly, get an offer this summer.

Just talked with an alum of my 40ish school who graduated with horrible grades, got a state trial court clerkship, which got him a federal clerkship, which got him a job at a big firm. So, yes, it can happen.