Certified Treasury Professional Exam Dumps

CTP Exam Format | Course Contents | Course Outline | Exam Syllabus | Exam Objectives

General Information
The Certified Treasury Professional (CTP)
The CTP Examination
Eligibility Requirements
Exam Format
Test Development
Job Analysis
Test Specifications
Body of Knowledge
The Exam
2020-2022 CTP Test Specifications:
Knowledge Domains and Task Statements
Exam Locations/Dates/Fees
Test Center Locations
2020 CTP Examination Testing Windows
and Deadlines
2020 New Applicant Fees
Other Fees
Cancellation Policy
Deferrals / Special Circumstances
Taking the CTP Exam
Submitting Your Application
AuthorizationToTest (ATT)
Scheduling Your Examination Appointment
Testing Time
Requesting Special Testing Accommodations
Making Changes
Exam Results
CTP Study Resources
Essentials of Treasury Management, Sixth Edition
CTP Exam Prep Platform
CTP Examination Preparation Guide
CTP Exam Study Network
Complimentary Webinars
CTP Exam Review Course
Regional AFP/TMA Organizations
Maintaining Your CTP Credential
CTP Recertification and Reporting Continuing
Education (CE) Credits
Approved CE Activities
Activities Not Approved for CE Credits

Each question on the CTP exam is referenced to the content of Essentials of Treasury Management, Sixth Edition, the Body of Knowledge (BOK) for the CTP exam. The computer-based exam includes 170 multiple-choice questions and is built according to the CTP Test Specifications on page 5 of this handbook. Test development for the CTP exam is based on psychometrically validated procedures. Pearson VUE and AFP ensure the CTP exam is valid, reliable and legally defensible.

Domain 1
Maintain corporate liquidity required to meet current and future obligations in a timely and cost effective manner
A. Manage optimal cash positioning through short-term investing and borrowing activities
B. Forecast/manage cash receipts and disbursements [cash flows]
C. Leverage cash concentration/pooling structures
D. Manage foreign exchange (FX) exposure
E. Manage trade financing (including letters of credit)
F. Manage intercompany financing (including loans, repatriation, in-house banking)
G. Review cash balances and reconcile transaction activity to ensure accuracy
H. Optimize treasury operations (including considerations for roles/responsibilities and outsourcing options)
I. Calculate, analyze, and evaluate financial ratios to optimize financial decision making

Domain 2
Manage capital structure, manage costs of long-term capital, and quantitatively evaluate long-term capital resource investments
A. Negotiate and manage syndicated agreements
B. Manage investment portfolio
C. Issue debt and equity
D. Manage revolving debt agreements
E. Assess impact of mergers, acquisitions, and divestitures
F. Evaluate current market conditions (including credit availability, spreads, interest rates, terms, risk) as they relate to long-term borrowing strategies

Domain 3
Manage internal and external relationships
A. Build, maintain, and review relationships with external financial service providers
B. Evaluate and implement treasury products and services (including banking products, treasury workstations)
C. Administer bank accounts (including bank fee analysis) and maintain documentation
D. Identify, negotiate, and select relationships and operational agreements with external service providers (including financial, technological, and investment/retirement advisors) to ensure best practices and competitive pricing
E. Serve as an internal trusted advisor and consultant (including Project Finance)
F. Manage merchant services programs (including fees, risk, controls, card security compliance, retention requirements)
G. Build and maintain relationships with internal stakeholders (including accounting, IT, legal, and tax departments) H. Market Effects on Working Capital

Domain 4
Monitor and control corporate exposure to financial, regulatory, and operational risk (including emerging and reputational risk)
A. Comply with treasury policies and procedures (such as investment, FX, risk management, hedging, credit approval)
B. Draft treasury policies and procedures for approval (such as investment, FX, risk management, hedging, credit approval)
C. Detect and mitigate fraud (such as payments, bank transactions, internal, external)
D. Benchmark performance against external sources to ensure best practices (including banking fees comparative analysis)
E. Evaluate and manage counterparty risk (including risk related to supply chain, banks, brokers, dealers)
F. Develop, maintain, and test business continuity plans (including bank balance reporting process, funds transfer capabilities)
G. Hedge FX, interest rate, and commodities exposure
H. Ensure regulatory compliance, and report internally and externally on compliance

Domain 5
Assess impact of technologies on the treasury function
A. Leverage technology systems (including enterprise resource planning (ERP) systems and treasury management systems)
B. Identify security issues and concerns associated with new and existing technology
C. Identify cyber-related risks
D. Monitor information security risk and cyber-related risk (including e-mail scams, phishing scams)

3337% of the questions test knowledge of basic facts and terms.
3842% of the questions test an understanding of concepts and principles.
2327% of the questions test the higher thinking ability to apply concepts and principles to a specific situation.
1015% of the questions will require mathematical computations.

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Preoperative contrast of sufferers With Liver ailment

Estimating The possibility of surgical procedure

owing to the lack of giant, prospective experiences, the assessment of operative risk is an inexact science. Postoperative effects are markedly influenced by means of the severity and nature of the underlying liver sickness and the class of surgery being considered.[16,17]

Obstructive jaundice. The presence of underlying obstructive jaundice markedly raises perioperative mortality, and a number of reports have reported risk components for elevated mortality in sufferers with this circumstance. These risk factors encompass an preliminary hematocrit of above 30%, a serum total bilirubin awareness above eleven mg/dl, the presence of malignancy, a serum creatinine concentration higher than 1.4 mg/dl, serum albumin awareness bigger than 3.0 g/dl, age older than sixty five years, aspartate aminotransferase awareness above ninety IU/l, and blood urea nitrogen concentration above 19 mg/dl.[18,19,20]

Acute hepatitis. patients with acute hepatitis have improved morbidity and mortality associated with surgical procedure.[21,22] These increases doubtless turn up on account of the acute hepatocellular harm and linked hepatic dysfunction. As most instances of acute hepatitis are self-restricted and signs ultimately get to the bottom of, elective surgery should be postponed unless the affected person's medical, biochemical and histologic parameters return to baseline. similarly, usual morbidity and mortality are accelerated in patients with acute alcoholic hepatitis, and non-obligatory surgery is contraindicated in these patients.[23]

persistent hepatitis. The etiology of continual hepatitis does not seem to have an effect on a affected person's perioperative chance, although particular conditions warrant special consideration (see below). surgery is considered safe in asymptomatic patients with histologic evidence of mildly energetic hepatitis, whereas symptomatic patients with histologic evidence of severely active hepatitis had been proven to be at expanded risk from surgical procedure.[24,25,26] The presence of underlying hepatic dysfunction increases perioperative risk. In sufferers with persistent hepatitis led to by using both alcoholic or nonalcoholic steatohepatitis, one analyze stated a trend towards elevated morbidity and mortality in sufferers with average to severe steatosis (>30%) who underwent fundamental hepatic resection.[27] These sufferers' imply BMI became enhanced than 30 kg/m2, and their preoperative bilirubin stages were elevated (mean 2.2 mg/dl), which indicated enormous underlying hepatic dysfunction.[27]

Cirrhosis. In patients with cirrhosis, perioperative possibility can also be influenced by using hepatic dysfunction, portal hypertension and problems akin to intra-abdominal varices, ascites, renal dysfunction, and portopulmonary hypertension.

An accurate evaluation of the extent and severity of the patient's underlying liver sickness is required for a very good choice of their perioperative risk. The baby–Turcotte–Pugh (CTP) rating and the model for end-stage Liver disease (MELD) rating have both been used for this purpose.

newborn–Turcotte–Pugh score. The CTP score turned into the first-described predictor of surgical possibility—this score changed into firstly designed through infant and Turcotte to predict mortality after portocaval shunt surgical procedure, and was later modified by Pugh et al. to encompass prothrombin time in area of dietary reputation for use in sufferers present process esophageal transections of bleeding varices ( table 1 ).[28,29] youngsters the CTP rating has now not been prospectively validated, it has stood the check of time, and has been accepted to verify ailment severity in patients with cirrhosis and to predict their hazards of perioperative morbidity and mortality for each optional and emergency surgical procedure.[30,31,32] In cirrhotic sufferers who bear abdominal surgery, CTP courses A, B and C are linked to mortality of 10%, 30–31% and seventy six–82%, respectively.[1,32]

The subjective nature of the clinical parameters and the arbitrary cut-off facets used for the biochemical parameters restrict the accuracy of the CTP ranking as a predictor of surgical possibility. An instance of the barriers of the CTP rating is shown by means of the fact that patients with CTP classification A cirrhosis can nonetheless have ascites, hyperbilirubinemia and portal hypertension.[33] for that reason, option methods were sought that estimate the severity of underlying hepatic dysfunction greater precisely.

model for end-Stage Liver sickness. The MELD ranking become in the beginning devised as a prognostic measure of brief-time period mortality in patients with cirrhosis who were undergoing placement of a transjugular intrahepatic portosystemic shunt.[34] The MELD assigns the patient a score of 8–40, which is derived from a complex method that contains three biochemical variables—the serum total bilirubin concentration, serum creatinine awareness, and international normalized ratio (INR, see container 1). The MELD ranking has been prospectively validated as a prognostic marker of mortality in patients with cirrhosis, acute variceal bleeding or acute alcoholic hepatitis.[36,37,38] A modified MELD ranking changed into adopted via the United network for Organ Sharing in February 2002 for the applications of donor liver allocation.[35]

The MELD rating became first evaluated for use in the preoperative opinions of a series of sufferers with cirrhosis who were scheduled to endure cholecystectomy (determine 1).[39] during this study, each the MELD and the CTP ratings precisely predicted postoperative morbidity, with areas beneath the receiver operating attribute curve (AUCs) of 0.938 and nil.839, respectively. sufferers with a MELD ranking above 8 have been extra more likely to have postoperative problems, including demise, than those with a MELD ranking under 8 (forty four% vs 10%). in a similar fashion, in a analyze of cirrhotic sufferers scheduled to endure cardiac surgery with cardiopulmonary bypass, each the preoperative CTP and MELD scores correlated totally with postoperative hepatic decompensation and mortality, with AUCs of 0.eighty four and zero.89, respectively.[40]

C-records for the use of the CTP or MELD score in prediction of 30-day postoperative mortality, or amortality and morbidity, in patients with cirrhosis. A high C-statistic value indicates the multiplied accuracy of the score. each the CTP and the MELD scores are valuable to predict consequences after surgical approaches in sufferers with advanced liver sickness. statistics were received from references 39, forty and forty three. Abbreviations: CTP, infant–Turcotte–Pugh; MELD, mannequin for end-Stage Liver ailment.

different reports have evaluated the universal utility of the MELD ranking in patients with cirrhosis, but have blanketed a number of various kinds of techniques. The classification of surgical procedure carried out has a huge effect on outcomes (see below), and the outcomes of those studies cannot, for this reason, be directly applied to people. in one look at of forty cirrhotic patients who underwent quite a few optionally available and emergency approaches, each MELD and CTP rankings correlated with postoperative mortality at 1 and 3 months.[41] In yet another analyze of 53 cirrhotic sufferers who underwent belly surgical procedure, a preoperative MELD score of 14 or enhanced was superior to CTP class C for prediction of either dying or need for transplantation at 90 days (seventy seven% vs 23%).[42] In a study by using Northup et al.,[43] it turned into referred to that the 30-day mortality from nontransplant surgical procedure in cirrhotic sufferers improved by using 1% for MELD ratings between 6 and 20, with an additional 2% per point for scores above 20. This assistance has restricted value for particular person affected person counseling, despite the fact; these analyses were reported on a per-manner in preference to per-affected person groundwork, typical mortality from abdominal tactics become excessive, and procedure-selected mortality in this community became not stated.[43] The AUC of the MELD score when used to predict 30-day mortality for all methods was 0.72, but changed into significantly greater for intra-belly surgery (0.87), which indicated that there are variations in possibility for specific sorts of approaches and emphasized the need for process-certain effects records.

different tactics. choice strategies used to examine the severity of hepatic ailment consist of liver scintigraphy (the use of 99mTc-galactosyl-labeled human serum albumin), the indocyanine-eco-friendly retention check, the aminopyrine breath examine, and size of the lidocaine metabolite monoethylglycinexylidide.44-forty six] besides the fact that children these processes can provide a quantitative evaluation of hepatic feature, these techniques don't seem to be greatly obtainable and are hardly ever used, except to examine a affected person's hepatic reserve all the way through their contrast as a candidate for resection.

Emergency surgery. a couple of reports have proven that patients with cirrhosis who undergo any emergency surgery, specially emergency belly surgery or surgical procedure on account of trauma, have a stronger mortality than sufferers with common hepatic function. patient outcomes worsen with increasing CTP ratings.[47,48]

stomach surgical procedure. stomach surgical approaches—akin to gastric skip, biliary methods, ulcer surgical procedure and colonic resections—enhance morbidity and mortality in sufferers with cirrhosis.[49,50] Likewise, morbidity and mortality are also elevated in patients with cirrhosis who endure cholecystectomy, despite the fact the possibility appears to be highest for those who bear nonlaparoscopic and emergency cholecystectomy.[51,52] Two small sequence have reported the preoperative placement of transjugular intrahepatic portosystemic shunts in sufferers with cirrhosis and portal hypertension, for whom stomach surgery would otherwise be contraindicated, to improve portal hypertension and allow surgery to be effectively accomplished.[53,54]

Cardiac surgery. In sufferers with cirrhosis, cardiac surgery that requires cardiopulmonary pass has an expanded perioperative possibility. The published experiences pronounced are all small, but all have proven increases in postoperative complications and mortality. as an example, in a single look at of 13 patients, no deaths have been pronounced in sufferers with CTP classification A cirrhosis, but mortality changed into 80% in sufferers with CTP classification B cirrhosis or improved.[55] The increased morbidity and mortality have been led to by using an accelerated incidence of bleeding and sepsis and had been felt to be unrelated to cardiac issues.[55] the same analyze of 18 patients who underwent cardiac surgery with cardiopulmonary skip tested mortality costs of 0%, 50%, and 100% for patients with CTP classes A, B, and C, cirrhosis, respectively.[56]

In 2004, a comparatively massive analyze of 44 cirrhotic patients who underwent optionally available cardiac surgical procedure (coronary artery pass grafting, valve surgery, or pericardiectomy) became posted, which also cited a robust affiliation between CTP score and postoperative mortality: sufferers with a CTP rating of 8 or higher had vastly better postoperative mortality than these with a CTP ranking below 8.[40]

Hepatic resection. Surgical resection of localized hepatocellular carcinoma in sufferers with cirrhosis raises considerations concerning the adequacy of residual hepatic reserve, specifically in those that have advanced cirrhosis and portal hypertension. These patients have multiplied prices of perioperative complications, lengthy-term hepatic decompensation, and death following resection, and as a result affected person preference is vital.[57] Refinements in patient choice, early diagnosis and more desirable surgical options have, besides the fact that children, ended in stronger perioperative mortality and 5-12 months survival.[58] The absence of portal hypertension measured by hepatic vein catheterization (a hepatic vein power gradient <10 mmHg) and a traditional serum complete bilirubin awareness have been shown to be advanced predictors of influence after surgery, with 5-12 months survival prices above 70%. against this, an multiplied hepatic vein drive gradient (>10 mmHg) and an accelerated complete bilirubin attention of (>1 mg/dl) are linked to 5-12 months survival prices beneath 30%, even with the patient's CTP classification.[59]


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