I have a database with an Items table that looks something like this:
id
name
category (int)
There are several hundred thousan
Please note: in the following example I am assuming your table is named "items" not "Items" because you also said the other table was named "categories" (second table name not capitalized).
The SQL for what you want to do would roughly be:
`SELECT items.id AS item_id,
items.name AS item_name,
items.category AS item_category_id,
categories.id AS category_id,
categories.category AS category_name
FROM items, category
WHERE items.category = categories.id
ORDER BY rand()
LIMIT 1`