quick untested code:

my $file = do { local $/; <FILE> }; # slurp
my @questions = $file =~ /(^question.*\n(?:(?!question).*\n)*)/gm;
for (1..10) { # 10 questions at random
  my ($one) = splice @questions, rand @questions, 1;
  my %param = $one =~ /^(\w+)=(.*)/gm;
  print $param{question}, "\n";
  print "$_: ", $param{"option$_"}, "\n" for 1..4;
  ... etc ...
}
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-- Randal L. Schwartz, Perl hacker