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I think this doesn't scale well. The root level nodes Symptoms and Discharge are examples, but there might 1-n root nodes, whose string could also appear elsewhere in the hierarchy.
"FK is also part of the primary key (PK) for that table." Are you referring to creating a composite key here? Any particular reason to require a composite key rather than just a PK or no PK at all?
How would I specify the answer choices in OPTION? I'm thinking: Create a new row for every answer choice of every question (which could lead to hundreds of rows), and each answer choice is is tied to QUESTION with a foreign key. Then when populating a question, query for all answers associated with it.
